Provider Demographics
NPI:1447759055
Name:PAUL, JULIE A (PA)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:PAUL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:BASILE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5298 SOCIALVILLE FOSTER RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-9302
Mailing Address - Country:US
Mailing Address - Phone:513-770-4212
Mailing Address - Fax:513-770-4213
Practice Address - Street 1:5298 SOCIALVILLE FOSTER RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-9302
Practice Address - Country:US
Practice Address - Phone:513-770-4212
Practice Address - Fax:513-770-4213
Is Sole Proprietor?:No
Enumeration Date:2018-02-09
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.005192RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant