Basic Information
| Provider Information | |||||||||
| NPI: | 1932306149 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARTWRIGHT | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | THOMAS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1038 | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319021038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7066602950 | ||||||||
| FaxNumber: | 7066602975 | ||||||||
| Practice Location | |||||||||
| Address1: | 2737 WARM SPRINGS RD | ||||||||
| Address2: | BUILDING A | ||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319046859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7066602950 | ||||||||
| FaxNumber: | 7066602975 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2007 | ||||||||
| LastUpdateDate: | 02/02/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 65089 | GA | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 003134994A | 05 | GA | MEDICAID | 003134994B | 05 | GA | MEDICAID | 58 1719867 047 | 01 | GA | BCBS | OTHER | 65089 | 01 | GA | GEORGIA | OTHER | 602-03641 | 01 | AL | BCBS | OTHER |