Provider Demographics
NPI:1801869193
Name:CARR, PAULA (MD)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:JUBILEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3495 PIEDMONT ROAD, NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-504-5678
Mailing Address - Fax:
Practice Address - Street 1:3650 STEVE REYNOLDS BLVD
Practice Address - Street 2:KAISER PERMANENTE GWINNETT MEDICAL CENTER
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096
Practice Address - Country:US
Practice Address - Phone:770-931-6012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058937207Q00000X
GA076664207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA541595397OtherVIRGINIA HEALTH NETWORK
VA27575OtherSENTARA/OPTIMA
VA010211719Medicaid
VA541595397OtherVIRGINIA PREMIER
VA4399936OtherAETNA
VA541595397035OtherTRICARE
VA183922OtherANTHEM
VAH26063Medicare UPIN
VA541595397035OtherTRICARE