Provider Demographics
NPI:1841363355
Name:PAUL TAUPEKA MD PC
Entity type:Organization
Organization Name:PAUL TAUPEKA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:TAUPEKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-943-4600
Mailing Address - Street 1:250 STATE FARM PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7181
Mailing Address - Country:US
Mailing Address - Phone:205-943-4600
Mailing Address - Fax:205-943-4688
Practice Address - Street 1:3290 DAUPHIN ST
Practice Address - Street 2:SUITE 401
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4062
Practice Address - Country:US
Practice Address - Phone:251-471-3309
Practice Address - Fax:251-471-5046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALDB3035OtherRR MEDICARE PGBA
AL1841363355Medicaid
AL529919190Medicaid
ALJ699Medicare ID - Type Unspecified
AL1841363355Medicare PIN
AL529919190Medicaid
MS00119199Medicaid
MS00555217Medicaid
MS06304011Medicaid
FLK9561Medicare ID - Type Unspecified