Provider Demographics
NPI:1639106503
Name:ISRAEL, PAUL G (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:G
Last Name:ISRAEL
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 1:303 WILLIAMS AVE
Mailing Address - Street 2:STE 1121
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4249
Mailing Address - Country:US
Mailing Address - Phone:256-536-1081
Mailing Address - Fax:256-536-1082
Practice Address - Street 1:303 WILLIAMS AVE
Practice Address - Street 2:STE 1121
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4249
Practice Address - Country:US
Practice Address - Phone:256-536-1081
Practice Address - Fax:256-536-1082
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL124002080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
89675Medicare ID - Type Unspecified
E86168Medicare UPIN