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Individual

MICHAEL J PALKO III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
510 E OGLETHORPE HWY, HINESVILLE, GA 31313
(912) 369-7546
(478) 328-0438
Mailing address
2400 BELLEVUE RD, SUITE 21-A, DUBLIN, GA 31021-2885
(478) 275-7202
(478) 274-8418

Taxonomy

Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
049863
GA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
049863
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000977171C
GA
01
DC4061
RAILROAD MEDICARE
GA
01
P00176683
RAILROAD MEDICARE
GA
Enumeration date
11/15/2005
Last updated
04/23/2015
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