Provider Demographics
NPI:1417038001
Name:TOPOL, PAUL JIRI (MD)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:JIRI
Last Name:TOPOL
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 1:2 MARINE WAY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801
Mailing Address - Country:US
Mailing Address - Phone:907-209-8962
Mailing Address - Fax:866-581-8172
Practice Address - Street 1:2 MARINE WAY
Practice Address - Street 2:SUITE 204
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-209-8962
Practice Address - Fax:866-581-8172
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA076002084P0800X
AKBT79014012084P0800X
AKXT79014012084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK5960OtherMD
AKMD2333Medicaid
AKMDG230Medicaid
010005602 00OtherAMERICHOICE
100837428 0001OtherPA CAID
223315602OtherAETN
2322058000OtherAMERIHEATH, HMO, KEYSTONE, IBC
P3013400OtherOXFORD HEALTH PLAN
001664713OtherAMERIHEALTH PPO
072446AVUMedicare PIN
100837428 0001OtherPA CAID
H92249Medicare UPIN
072446AVUMedicare PIN