Provider Demographics
NPI:1275511784
Name:MEGEHEE, PAUL JACOB (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JACOB
Last Name:MEGEHEE
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 1:408 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-2424
Mailing Address - Country:US
Mailing Address - Phone:256-259-5211
Mailing Address - Fax:256-259-6641
Practice Address - Street 1:408 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-2424
Practice Address - Country:US
Practice Address - Phone:256-259-5211
Practice Address - Fax:256-259-6641
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25257207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009932095Medicaid
AL25257OtherSTATE LICENSE
AL051517447Medicare ID - Type Unspecified
ALH93957Medicare UPIN