Provider Demographics
NPI:1013778844
Name:BARTL, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:BARTL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9305 SHAY LAKE DRIVE
Mailing Address - Street 2:205R
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241
Mailing Address - Country:US
Mailing Address - Phone:440-317-3489
Mailing Address - Fax:
Practice Address - Street 1:9305 SHAY LAKE DRIVE
Practice Address - Street 2:205R
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241
Practice Address - Country:US
Practice Address - Phone:440-317-3489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No376J00000XNursing Service Related ProvidersHomemaker