Provider Demographics
NPI:1952303158
Name:JANIS, PAUL JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JOSEPH
Last Name:JANIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-2122
Mailing Address - Country:US
Mailing Address - Phone:317-738-2181
Mailing Address - Fax:317-738-4736
Practice Address - Street 1:950 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-2122
Practice Address - Country:US
Practice Address - Phone:317-738-2181
Practice Address - Fax:317-738-4736
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002592152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN591070AMedicare PIN
IN0263910001Medicare NSC
INU33895Medicare UPIN