Individual
DR. WILSON GUINN PAULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
262 MITYLENE PARK DR, MONTGOMERY, AL 36117-3548
(334) 260-8511
(334) 260-8755
Mailing address
262 MITYLENE PARK DR, MONTGOMERY, AL 36117-3548
(334) 260-8511
(334) 260-8755
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
16479
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051519733
—
AL
01
—
51520076
BLUE CROSS BLUE SHIELD
AL
Enumeration date
06/22/2006
Last updated
01/10/2013
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