Organization
JEFFREY K CHAULK MD PC
Active
Organization
JEFFREY K CHAULK MD PC
Active
Other names
Alpine Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY K CHAULK M.D. (OWNER)
(989) 732-6455
Entity
Organization
Contact information
Practice address
350 W NORTH ST, GAYLORD, MI 49735-1525
(989) 732-6455
(989) 732-1102
Mailing address
PO BOX 1665, GAYLORD, MI 49734-5665
(989) 732-6455
(989) 732-1102
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
4901003939
MI
152W00000X
Optometrist
4901004074
MI
207W00000X
Ophthalmology Physician
Primary
4301405077
MI
207W00000X
Ophthalmology Physician
5101016992
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1806920011
BLUE CARE NETWORK
MI
01
—
180F910760
BCBS MD
MI
01
—
180F910770
BCBS OD
MI
05
—
3038315
—
MI
01
—
900F910770
BLUE CARE NETWORK
MI
01
—
CJ0562
RAILROAD MEDICARE
MI
Enumeration date
02/28/2007
Last updated
07/20/2010
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