Basic Information
| Provider Information | |||||||||
| NPI: | 1942695390 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OVERDORF | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4229 BRUSHFIELD CT APT F | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171094903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5188594933 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9913 N 95TH ST | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852584586 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808608998 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2015 | ||||||||
| LastUpdateDate: | 07/05/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 007882 | AZ | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.