Provider Demographics
NPI:1790979946
Name:PAUL, MARLO E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARLO
Middle Name:E
Last Name:PAUL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 9
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35464
Mailing Address - Country:US
Mailing Address - Phone:865-368-9390
Mailing Address - Fax:855-301-8116
Practice Address - Street 1:6228 COUNTY ROAD 28
Practice Address - Street 2:
Practice Address - City:SAWYERVILLE
Practice Address - State:AL
Practice Address - Zip Code:36776-5577
Practice Address - Country:US
Practice Address - Phone:334-624-2553
Practice Address - Fax:855-301-8116
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.28217207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine