Provider Demographics
NPI:1205974326
Name:TAYOUN, PAUL J (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:TAYOUN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:101 S CHURCH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-6279
Mailing Address - Country:US
Mailing Address - Phone:570-501-1017
Mailing Address - Fax:570-501-2695
Practice Address - Street 1:101 S CHURCH ST
Practice Address - Street 2:SUITE B
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-6279
Practice Address - Country:US
Practice Address - Phone:570-501-1017
Practice Address - Fax:570-501-2695
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2022-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS007636L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012696090010Medicaid
PA0012696090006Medicaid