Provider Demographics
NPI:1699726216
Name:DESCHENES, PAUL (PSYD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:DESCHENES
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 MURRAY GUARD DR STE B
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-3742
Mailing Address - Country:US
Mailing Address - Phone:731-660-0199
Mailing Address - Fax:731-660-3650
Practice Address - Street 1:174 MURRAY GUARD DR STE B
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3742
Practice Address - Country:US
Practice Address - Phone:731-660-0199
Practice Address - Fax:731-660-3650
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000000897103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3683444Medicare ID - Type UnspecifiedMEDICARE NUMBER