Provider Demographics
NPI:1588641260
Name:COLON, PAUL A (DPM)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:COLON
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Gender:M
Credentials:DPM
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Mailing Address - Street 1:425 FOREST PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-2185
Mailing Address - Country:US
Mailing Address - Phone:404-363-9944
Mailing Address - Fax:404-363-9951
Practice Address - Street 1:425 FOREST PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-2185
Practice Address - Country:US
Practice Address - Phone:404-363-9944
Practice Address - Fax:404-363-9951
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2012-03-22
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Provider Licenses
StateLicense IDTaxonomies
GA000355213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U17634Medicare UPIN