Individual
PAUL D DIEBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6801 DIXIE HWY, SUITE 127, LOUISVILLE, KY 40258-3913
(502) 935-5633
(502) 395-5706
Mailing address
6801 DIXIE HWY, SUITE 127, LOUISVILLE, KY 40258-3913
(502) 935-5633
(502) 395-5706
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
24046
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
610956698-00
BLUE SHIELB
KY
Enumeration date
11/22/2005
Last updated
05/12/2009
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