Provider Demographics
NPI:1659716041
Name:SCHOFIELD, PAUL DAVID (PA-C)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:DAVID
Last Name:SCHOFIELD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 JENNINGS MILL RD BLDG 300-110
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7238
Mailing Address - Country:US
Mailing Address - Phone:706-613-5880
Mailing Address - Fax:
Practice Address - Street 1:1305 JENNINGS MILL RD BLDG 300-110
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7238
Practice Address - Country:US
Practice Address - Phone:706-613-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006831363A00000X
GA6831363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003135210BMedicaid
GA003135210BMedicaid