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Individual

PAUL E TATUM III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
4107 SPICEWOOD SPRINGS RD STE 100, AUSTIN, TX 78759-8645
(512) 397-3360
(512) 343-7107

Taxonomy

Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
036160360
IL
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
2022022258
MO
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
R9296
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
807026
AZ
Enumeration date
11/09/2005
Last updated
04/02/2025
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