Gentry, Paul Douglas

Gentry, Paul Douglas is an individual health care provider with primary practice located at 624 Dixie Street , Carrollton GA 30117-3817. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gentry, Paul Douglas can be contacted via phone (770) 832-9593.

Contact Information

Primary practice address
624 Dixie Street Carrollton GA 30117-3817
Fax: (770) 832-0440
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 017577 Georgia

Profile Details

NPI number 1699879338
LBN Legal business name Gentry, Paul Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699879338 NPPES
Georgia MEDICAID 00147815A

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