Provider Demographics
NPI:1265429401
Name:PAUL, HOWARD S (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:S
Last Name:PAUL
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 1:1969 W HART ROAD
Mailing Address - Street 2:BELOIT HEALTH SYSTEM COUNSELING CARE CENTER
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-2230
Mailing Address - Country:US
Mailing Address - Phone:608-364-5684
Mailing Address - Fax:608-363-5756
Practice Address - Street 1:1969 W HART ROAD
Practice Address - Street 2:BELOIT HEALTH SYSTEM COUNSELING CARE CENTER
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-2230
Practice Address - Country:US
Practice Address - Phone:608-364-5684
Practice Address - Fax:608-363-5756
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI360772084P0800X
WI36077-202084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32078100Medicaid
WI32078100Medicaid
32078100Medicare ID - Type Unspecified