Provider Demographics
NPI:1881017119
Name:DEMOS, PAUL THOMAS (JD, MBA, BS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:THOMAS
Last Name:DEMOS
Suffix:
Gender:M
Credentials:JD, MBA, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5045 N 12TH ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-3374
Mailing Address - Country:US
Mailing Address - Phone:602-595-5210
Mailing Address - Fax:
Practice Address - Street 1:5045 N 12TH ST
Practice Address - Street 2:SUITE 108
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-3374
Practice Address - Country:US
Practice Address - Phone:602-595-5210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor