Paulk, Charles Ted

Paulk, Charles Ted is an individual health care provider with primary practice located at 1245 Westgate Pkwy , Dothan AL 36303. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Paulk, Charles Ted can be contacted via phone (334) 793-9595.

Contact Information

Primary practice address
1245 Westgate Pkwy Dothan AL 36303
Phone: (334) 793-9595
Fax: (334) 793-1578
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 6629 Alabama

Profile Details

NPI number 1366429649
LBN Legal business name Paulk, Charles Ted
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2005
Last updated Nov 12th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366429649 NPPES
Alabama MEDICAID 000004912
Alabama MEDICAID 000018990
Alabama Other 051004912
Alabama Other 051018990

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