Provider Demographics
NPI:1477696110
Name:NOLES, PAUL S
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:S
Last Name:NOLES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 CROSSROADS CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344-5819
Mailing Address - Country:US
Mailing Address - Phone:731-986-4411
Mailing Address - Fax:
Practice Address - Street 1:1355 CROSSROADS CHURCH RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-5819
Practice Address - Country:US
Practice Address - Phone:731-986-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator