Provider Demographics
NPI:1659135465
Name:PAUL, NOILY III
Entity Type:Individual
Prefix:MR
First Name:NOILY
Middle Name:
Last Name:PAUL
Suffix:III
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 1:2741 BAYOU BOEUF DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-6569
Mailing Address - Country:US
Mailing Address - Phone:504-722-7549
Mailing Address - Fax:
Practice Address - Street 1:2741 BAYOU BOEUF DR
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-6569
Practice Address - Country:US
Practice Address - Phone:504-722-7549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver