Provider Demographics
NPI:1376755538
Name:MEFFERD, PAUL L (DO)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:L
Last Name:MEFFERD
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:790 CHURCH ST NE
Mailing Address - Street 2:SUITE 550
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7282
Mailing Address - Country:US
Mailing Address - Phone:770-419-9902
Mailing Address - Fax:770-419-7457
Practice Address - Street 1:790 CHURCH ST NE
Practice Address - Street 2:SUITE 550
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7282
Practice Address - Country:US
Practice Address - Phone:770-419-9902
Practice Address - Fax:770-419-7457
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2019-09-17
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Provider Licenses
StateLicense IDTaxonomies
GA0546172081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003141012AMedicaid
GA1710946322OtherGROUP NPI