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Individual
DR. CLYDE DODSON PAULK
Active
Individual
DR. CLYDE DODSON PAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C3204
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01020368
UNITED HEALTHCARE
AR
05
—
102505001
—
AR
01
—
14003000000
QUALCHOICE
AR
01
—
383494
HEATLHLINK
AR
01
—
4295730
AETNA
AR
01
—
770023201
BREASTCARE
AR
Enumeration date
03/15/2006
Last updated
06/30/2009
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