Provider Demographics
NPI:1861463705
Name:GORLIN, PAULA LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:LYNN
Last Name:GORLIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 LAKESPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338
Mailing Address - Country:US
Mailing Address - Phone:404-964-4532
Mailing Address - Fax:
Practice Address - Street 1:875 LAWRENCEVILLE SUWANEE RD
Practice Address - Street 2:STE 560
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043
Practice Address - Country:US
Practice Address - Phone:770-963-0370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1130T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00976962AMedicaid
911747OtherAETNA
910744OtherEYEMED
910744OtherEYEMED
U13230Medicare UPIN