Provider Demographics
NPI:1447237763
Name:MUMFREY, PAUL D II (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:D
Last Name:MUMFREY
Suffix:II
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:PO BOX 2705
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-2705
Mailing Address - Country:US
Mailing Address - Phone:256-265-4462
Mailing Address - Fax:256-265-4463
Practice Address - Street 1:401 LOWELL DR SE STE 1
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3738
Practice Address - Country:US
Practice Address - Phone:256-265-4462
Practice Address - Fax:256-265-4463
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1955207V00000X
AL43830207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S9290OtherBCBS
TX176595003Medicaid
TX176595004Medicaid
TX176595001Medicaid
TXP00815182Medicare PIN
TX8S9290OtherBCBS
TX8F1284Medicare PIN
TX176595001Medicaid
TX176595003Medicaid