Provider Demographics
NPI:1700310943
Name:PAUL, STEPHEN KYLE (DO)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:KYLE
Last Name:PAUL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1 PRESTIGE PL STE 550
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-6115
Mailing Address - Country:US
Mailing Address - Phone:937-762-1310
Mailing Address - Fax:937-522-8068
Practice Address - Street 1:1250 W NATIONAL RD STE 450
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45315-9505
Practice Address - Country:US
Practice Address - Phone:937-439-4145
Practice Address - Fax:937-439-4371
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-14
Last Update Date:2024-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34.015740207RB0002X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine