Individual
DR. PHILIP PAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 POINCIANA AVE, MAMOU, LA 70554-2243
(225) 803-6707
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
199960
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1057703
—
LA
Enumeration date
06/01/2006
Last updated
07/08/2007
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