MEDICARE: DR. KIRK ALAN PAULK M.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	207R00000X	Internal Medicine Physician	043739	GA

General Provider Information

NPI Number	:	1639191828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIRK ALAN PAULK M.D.

Provider Business Mailing Address
First Line	:	5885 GLENRIDGE DR NE
Second Line	:	SUITE 250
City	:	ATLANTA
State	:	GA
Zip	:	30328-5512
Country	:	US
Telephone Number	:	404-252-7226
Fax Number	:	404-252-8141

Provider Business Practice Location Address
First Line	:	5885 GLENRIDGE DR NE
Second Line	:	SUITE 250
City	:	ATLANTA
State	:	GA
Zip	:	30328-5512
Country	:	US
Telephone Number	:	404-252-7226
Fax Number	:	404-252-8141

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/09/2007

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