Provider Demographics
NPI:1326090796
Name:HLADON, PAUL ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ROBERT
Last Name:HLADON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5151 E GUADALUPE RD
Mailing Address - Street 2:#1073
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-7710
Mailing Address - Country:US
Mailing Address - Phone:480-773-5678
Mailing Address - Fax:
Practice Address - Street 1:1200 W MOHAVE RD
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:PARKER
Practice Address - State:AZ
Practice Address - Zip Code:85344-6349
Practice Address - Country:US
Practice Address - Phone:800-444-7009
Practice Address - Fax:800-305-3233
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ34890207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZI50179Medicare UPIN