Provider Demographics
NPI:1962465179
Name:FREE, PAUL E (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:E
Last Name:FREE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1240 HIGHWAY 54 W BLDG 700 STE 710
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214
Mailing Address - Country:US
Mailing Address - Phone:678-534-5922
Mailing Address - Fax:770-997-8504
Practice Address - Street 1:1240 HIGHWAY 54 W BLDG 700 STE 710
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4565
Practice Address - Country:US
Practice Address - Phone:770-991-2800
Practice Address - Fax:770-957-8504
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2022-02-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA043050207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA252419127A, B, CMedicaid
GA252419127A, B, CMedicaid
GA511I040025Medicare PIN