Provider Demographics
NPI:1437499969
Name:ZEAGLER, PAUL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:ZEAGLER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6068 HWY 98 W STE 1196
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-8883
Mailing Address - Country:US
Mailing Address - Phone:601-271-2742
Mailing Address - Fax:601-296-0189
Practice Address - Street 1:52 98 PLACE BLVD
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-8603
Practice Address - Country:US
Practice Address - Phone:601-271-2742
Practice Address - Fax:601-196-0189
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT5189225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist