Provider Demographics
NPI:1245334507
Name:LOCUS, PAUL ANDREW (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:ANDREW
Last Name:LOCUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 E WOOD ST
Mailing Address - Street 2:STE. 3
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-4421
Mailing Address - Country:US
Mailing Address - Phone:731-641-8720
Mailing Address - Fax:731-641-8736
Practice Address - Street 1:1323 E WOOD ST
Practice Address - Street 2:STE. 3
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4421
Practice Address - Country:US
Practice Address - Phone:731-641-8720
Practice Address - Fax:731-641-8736
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN52821207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D66831Medicare UPIN
TX85M912Medicare ID - Type Unspecified
D66831Medicare UPIN