Provider Demographics
NPI:1063546828
Name:SCHORR, PAUL J (PA-C)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:SCHORR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7153 BENNELL DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-6058
Mailing Address - Country:US
Mailing Address - Phone:740-654-0232
Mailing Address - Fax:
Practice Address - Street 1:7901 DILEY RD STE 260
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-9613
Practice Address - Country:US
Practice Address - Phone:614-920-1000
Practice Address - Fax:614-920-1007
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50-00-1604363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSCPA16531Medicare ID - Type Unspecified
OHP24332Medicare UPIN