Individual
DR. CLYDE DODSON PAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21 OPPORTUNITY DR, SHERIDAN, AR 72150-9185
(870) 942-9833
(870) 942-9837
Mailing address
21 OPPORTUNITY DR, SHERIDAN, AR 72150-9185
(870) 942-9833
(870) 942-9837
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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