Provider Demographics
NPI:1750470902
Name:SCHIFANELLA, PAUL JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JOSEPH
Last Name:SCHIFANELLA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:5358A HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-3604
Mailing Address - Country:US
Mailing Address - Phone:205-664-7577
Mailing Address - Fax:205-664-7654
Practice Address - Street 1:5358A HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AL
Practice Address - Zip Code:35080-3604
Practice Address - Country:US
Practice Address - Phone:205-664-7577
Practice Address - Fax:205-664-7654
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALSA44TA614152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051519691SCHMedicare PIN
ALU92499Medicare UPIN