Provider Demographics
NPI:1356449532
Name:LANCASTER, PAUL L (AUD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:L
Last Name:LANCASTER
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 N MILWAUKEE ST STE A
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-7107
Mailing Address - Country:US
Mailing Address - Phone:208-658-0238
Mailing Address - Fax:208-658-0302
Practice Address - Street 1:1740 N MILWAUKEE ST STE A
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-7107
Practice Address - Country:US
Practice Address - Phone:208-658-0238
Practice Address - Fax:208-658-0302
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPE 4084231H00000X
OR23383231H00000X
CAHT 8138237600000X
IDAUD-1599231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter