Provider Demographics
NPI:1669567509
Name:AUSTIN, PAUL F (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:F
Last Name:AUSTIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:C B 8242
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-454-6034
Mailing Address - Fax:314-747-4871
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:STE A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-6034
Practice Address - Fax:314-747-4871
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2016-11-14
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Provider Licenses
StateLicense IDTaxonomies
MO20001658872088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205081102Medicaid
MO340018452Medicare PIN
MO095010219Medicaid
MO095010219Medicare PIN