Provider Demographics
NPI:1366450132
Name:PAOUNCIC, EUGENE STEPHEN JR (DC)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:STEPHEN
Last Name:PAOUNCIC
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MEADOW DR
Mailing Address - Street 2:SUITE J
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2694
Mailing Address - Country:US
Mailing Address - Phone:770-843-3659
Mailing Address - Fax:
Practice Address - Street 1:101 MEADOW DR
Practice Address - Street 2:SUITE J
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2694
Practice Address - Country:US
Practice Address - Phone:770-843-3659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO07448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPA005125Medicare ID - Type Unspecified