Provider Demographics
NPI:1356364061
Name:TAUPEKA, PAUL MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MICHAEL
Last Name:TAUPEKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 SPRING HILL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-1416
Mailing Address - Country:US
Mailing Address - Phone:251-435-1200
Mailing Address - Fax:251-435-6357
Practice Address - Street 1:1720 SPRING HILL AVE STE 300
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1409
Practice Address - Country:US
Practice Address - Phone:251-435-1200
Practice Address - Fax:251-435-6357
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00020851207W00000X
AL20851207WX0200X, 207WX0109X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmology
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-47908OtherBC 3719 DAUPHIN STREET, MOBILE
ALC21622OtherHEALTHSPRING
AL515-47913OtherBC 6801 AIRPORT BLVD, MOBILE
ALG21622OtherVIVA
AL1356364061Medicare PIN
FL2654563-00Medicaid
FL62676AMedicare PIN
AL515-47910OtherBC 5 MOBILE INFIRMARY CIRCLE, MOBILE
AL7824708OtherCIGNA
AL515-47908OtherBC-3719 DAUPHIN STREET, MOBILE
AL510-10213OtherBC 1811 HAND AVENUE, BAY MINETTE
MS00119199Medicaid
MS00425871Medicaid
AL515-47914OtherBC 750 MORPHY AVENUE, FAIRHOPE
AL510-10215OtherBC 7101 US HIGHWAY 90, DAPHNE
MSC03326Medicare PIN
ALP00097247OtherRR MEDICARE PGBA
AL5878521OtherAETNA
AL515-47912OtherBC 6144 A AIRPORT BLVD, MOBILE
AL510-10214OtherBC 106 WEST JACKSON STREET, BREWTON
AL515-20498OtherBC 3290 DAUPHIN STREET, SUITE 401, MOBILE
AL1356364061Medicaid
MS06304011Medicaid
AL051520498Medicare PIN
AL1636472OtherFIRST HEALTH
FL2654563-00OtherFLORIDA MEDIPASS
G21622Medicare UPIN
AL515-47902OtherBC 2890 DAUPHIN ST, MOBILE
AL510-10208OtherBC 3016 SOUTH ALABAMA AVENUE, MONROEVILLE
AL051520498Medicaid
MS00555217Medicaid