Provider Demographics
NPI:1104091909
Name:PAUL M. JULIEN PLLC
Entity type:Organization
Organization Name:PAUL M. JULIEN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:JULIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-334-9009
Mailing Address - Street 1:PO BOX 808
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-0808
Mailing Address - Country:US
Mailing Address - Phone:802-334-9009
Mailing Address - Fax:802-334-9022
Practice Address - Street 1:637 UNION ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-5498
Practice Address - Country:US
Practice Address - Phone:802-334-9009
Practice Address - Fax:802-334-9022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0010859207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1011153Medicaid
VT1011153Medicaid
VTG94153Medicare UPIN