# EGLIN AIR FORCE BASE RESIDENCY PROGRAM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538504063
- **Authorized official:** DR. CHRISTOPHER PAULSON M.D. (PROGRAM DIRECTOR)
- **Authorized official phone:** (850) 883-8192

## Contact information

- **Practice address:** 11850 DR MARTIN LUTHER KING JR ST N, APT 22-312, ST PETERSBURG, FL 33716-1619
- **Practice address phone:** (206) 883-5357
- **Mailing address:** 11850 DR MARTIN LUTHER KING JR ST N, APT 22-312, ST PETERSBURG, FL 33716-1619
- **Mailing address phone:** (206) 883-5357

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | FL | Yes |
| 261Q00000X | Clinic/Center | — | FL | — |

## Other

- **Enumeration date:** 05/10/2013
- **Last updated:** 05/10/2013