MEDICARE: DR. PAULSEN COLEMAN ARNOLD O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1696	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0926F	OTHER	NC	BCBSNC PIN

General Provider Information

NPI Number	:	1811087786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAULSEN COLEMAN ARNOLD O.D.

Provider Business Mailing Address
First Line	:	2108 N PATTERSON ST
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602-2947
Country	:	US
Telephone Number	:	229-244-3000
Fax Number	:	229-244-0399

Provider Business Practice Location Address
First Line	:	232 GREEN ST
Second Line	:
City	:	WILLIAMSTON
State	:	NC
Zip	:	27892-2000
Country	:	US
Telephone Number	:	252-792-6611
Fax Number	:	252-799-0797

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	07/01/2021

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