Provider Demographics
NPI:1700582657
Name:CARON, PAUL BERNARD (DC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:BERNARD
Last Name:CARON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 GRANT PARK PL SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-1425
Mailing Address - Country:US
Mailing Address - Phone:703-843-8051
Mailing Address - Fax:
Practice Address - Street 1:503 AMSTERDAM AVE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-3416
Practice Address - Country:US
Practice Address - Phone:703-843-8051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010831111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty