Provider Demographics
NPI:1760473326
Name:STRONG, PAUL LEON (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:LEON
Last Name:STRONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 PINE ST
Mailing Address - Street 2:SUITE 309
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1103
Mailing Address - Country:US
Mailing Address - Phone:334-262-0342
Mailing Address - Fax:334-262-0390
Practice Address - Street 1:1722 PINE ST
Practice Address - Street 2:SUITE 309
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1103
Practice Address - Country:US
Practice Address - Phone:334-262-0342
Practice Address - Fax:334-262-0390
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL8918207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL8918OtherSTATE LICENSE
AL51007300Medicare ID - Type Unspecified
ALC74171Medicare UPIN