Individual
PAUL LAWRENCE DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4441 ATLANTA RD SE STE 213, SMYRNA, GA 30080-6442
(470) 956-9480
Mailing address
4441 ATLANTA RD SE STE 213, SMYRNA, GA 30080-6442
(470) 956-9480
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
019205
GA
207RI0011X
Interventional Cardiology Physician
Primary
019205
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00241788A
—
GA
01
—
060017368/CM0845
RAILROAD MEDICARE
GA
Enumeration date
09/02/2005
Last updated
10/31/2022
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