Healthcare Provider Details
I. General information
NPI: 1023170495
Provider Name (Legal Business Name): PAULDING ANESTHESIA ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 W MEMORIAL DR
DALLAS GA
30132-4117
US
IV. Provider business mailing address
PO BOX 72165
MARIETTA GA
30007-2165
US
V. Phone/Fax
- Phone: 770-443-7076
- Fax:
- Phone: 770-578-1800
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
A
BURNS
Title or Position: PRESIDENT
Credential: MD
Phone: 770-443-7076