Provider Demographics
NPI:1265494843
Name:HULL, PAUL Q (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:Q
Last Name:HULL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97281-3200
Mailing Address - Country:US
Mailing Address - Phone:503-274-4995
Mailing Address - Fax:503-274-4861
Practice Address - Street 1:2222 NW LOVEJOY ST
Practice Address - Street 2:408
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3033
Practice Address - Country:US
Practice Address - Phone:503-274-4995
Practice Address - Fax:503-274-4861
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7181207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR060015893OtherRAILROAD MEDICARE
ORROOOOBCBQXMedicare PIN