Provider Demographics
NPI:1578973723
Name:HEIN, PAUL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:HEIN
Suffix:JR
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 1:339 MEADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2414
Mailing Address - Country:US
Mailing Address - Phone:636-227-8108
Mailing Address - Fax:
Practice Address - Street 1:339 MEADOWBROOK DR
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-2414
Practice Address - Country:US
Practice Address - Phone:636-227-8108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO26872207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOUNKNOWN, RETIREDMedicare PIN