Provider Demographics
NPI:1396833620
Name:PAOLINI, RONALD (D O)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:PAOLINI
Suffix:
Gender:M
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 EAST HOSPITAL ROAD
Mailing Address - Street 2:ROOM 13A-10
Mailing Address - City:FORT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905-5650
Mailing Address - Country:US
Mailing Address - Phone:706-787-0401
Mailing Address - Fax:706-787-1327
Practice Address - Street 1:300 EAST HOSPITAL ROAD
Practice Address - Street 2:ROOM 13A-10
Practice Address - City:FORT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905-5650
Practice Address - Country:US
Practice Address - Phone:706-787-0401
Practice Address - Fax:706-787-1327
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0426872084P0301X, 2084P0802X
SC03412084P0301X, 2084P0802X
OH47232084P0802X
PAOS-005919-L2084P0802X
NC752972084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0301XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBrain Injury Medicine