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NPI Code Detail

MEDICARE: MICHAEL J. PAULK P.A.

MEDICARE: MICHAEL J. PAULK P.A.
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
1111N00000XChiropractorCH9322FL

General Provider Information

NPI Number : 1366874661
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHAEL J. PAULK P.A.
Provider Business Mailing Address
First Line : 1413 KINGSLEY AVE
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-4527
Country : US
Telephone Number : 904-264-3966
Fax Number : 904-278-7171
Provider Business Practice Location Address
First Line : 1413 KINGSLEY AVE
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-4527
Country : US
Telephone Number : 904-264-3966
Fax Number : 904-278-7171
Authorized Official
Title or Position : CHIROPRACITC PHYSICIAN/ OWNER
Name : DR. MICHAEL JOSEPH PAULK
Credential : D.C.
Telephone Number : 904-264-3966
Provider Enumeration Date : 08/08/2013
Last Update Date : 08/08/2013

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