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NPI Code Detail

MEDICARE: LAWRENCE ALAN GAULKIN MD

MEDICARE:   LAWRENCE ALAN GAULKIN  MD
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
1207Q00000XFamily Medicine PhysicianME0036411FL
2207Q00000XFamily Medicine Physician0101030483VA

General Provider Information

NPI Number : 1164423596
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAWRENCE ALAN GAULKIN MD
Provider Business Mailing Address
First Line : 1923 SEAGULL DR
Second Line :
City : CLEARWATER
State : FL
Zip : 33764-6621
Country : US
Telephone Number : 727-398-6661
Fax Number :
Provider Business Practice Location Address
First Line : 10000 BAY PINES BLVD
Second Line :
City : BAY PINES
State : FL
Zip : 33744
Country : US
Telephone Number : 727-398-6661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 05/19/2008

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Directions to “ LAWRENCE ALAN GAULKIN MD” Practice Location

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