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General NPI Number Information
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NPI Number | 1376552919
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Entity Type | Individual
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Provider Name | FREDERICK PAUL YILLING M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 09/10/2010
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Provider Practice Location Address
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Address Line | 20 GLENLAKE PARKWAY KAISER PERMANENTE GLANLAKE MEDICAL CENTER
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City | ATLANTA
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State | GA
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Zip | 30328
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Country | US
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Telephone | 404-351-7654
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Fax | 404-609-7605
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Provider Business Mailing Address
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Address Line | 3495 PIEDMONT ROAD, NE NINE PIEDMONT CENTER
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City | ATLANTA
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State | GA
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Zip | 30305
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Country | US
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Telephone | 404-364-7070
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Fax | 404-609-7605
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 025314
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 025314
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License Number State | GA
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