Individual
JOSEPH PAULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1200 MEMORIAL DR, DALTON, GA 30720-2529
(706) 278-2105
(865) 291-3228
Mailing address
PO BOX 634909, CINCINNATI, OH 45263-6019
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004465
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4111791
BCBS OF TENNESSEE
TN
01
—
P00310664
RAILRAOD MEDICARE
GA
Enumeration date
07/02/2006
Last updated
11/14/2007
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