Provider Demographics
NPI:1437232634
Name:PAUL, EUGENE ANTHONY SR (MD)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:ANTHONY
Last Name:PAUL
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:EUGENE
Other - Middle Name:A
Other - Last Name:PAUL
Other - Suffix:SR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8390 CHAMPIONS GATE BLVD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:CHAMPIONS GATE
Mailing Address - State:FL
Mailing Address - Zip Code:33896-8310
Mailing Address - Country:US
Mailing Address - Phone:407-390-1677
Mailing Address - Fax:407-390-1765
Practice Address - Street 1:1605 PEACHTREE ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-2433
Practice Address - Country:US
Practice Address - Phone:404-870-7746
Practice Address - Fax:404-870-7719
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA60305207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine