Healthcare Provider Details

I. General information

NPI: 1497945968
Provider Name (Legal Business Name): PAUL W JOYNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 09/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 EAGLES LANDING PKWY SUITE 260
STOCKBRIDGE GA
30281
US

IV. Provider business mailing address

35 COLLIER RD NW SUITE 475
ATLANTA GA
30309-1605
US

V. Phone/Fax

Practice location:
  • Phone: 404-351-7900
  • Fax: 404-351-7901
Mailing address:
  • Phone: 404-351-7900
  • Fax: 404-351-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number51826
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number074740
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: