Provider Demographics
NPI:1083078059
Name:DEICHMANN, PAUL C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:C
Last Name:DEICHMANN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1078 KNOLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2406
Mailing Address - Country:US
Mailing Address - Phone:205-427-6217
Mailing Address - Fax:
Practice Address - Street 1:1 N BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2521
Practice Address - Country:US
Practice Address - Phone:256-245-7474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14858183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist