Provider Demographics
NPI:1487623310
Name:FROULA, PAUL D (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:D
Last Name:FROULA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1932 ALCOA HWY STE 255
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1508
Mailing Address - Country:US
Mailing Address - Phone:865-244-2030
Mailing Address - Fax:865-684-1196
Practice Address - Street 1:1932 ALCOA HWY STE 255
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1508
Practice Address - Country:US
Practice Address - Phone:865-244-2030
Practice Address - Fax:865-684-1196
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN023507207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
100011868OtherPHP
2598799OtherCIGNA
180018265OtherRAILROAD MEDICARE
TN3066517Medicaid
4465387OtherAETNA
0840235OtherUNITED HEALTHCARE
0647640OtherUMWA
142653OtherBLUE CROSS BLUE SHIELD
TN0110OtherJOHN DEERE
180018265OtherRAILROAD MEDICARE
TN3066518Medicare PIN
TN3066518Medicare ID - Type Unspecified