Individual
JACK E PAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 SE 18TH AVE, BLDG 300, OCALA, FL 34471-8215
(352) 351-1313
(352) 351-1927
Mailing address
12109 CR 103, OXFORD, FL 34484-2967
(352) 391-6494
(352) 391-6498
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME34723
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067419200
—
FL
01
—
55112
BCBS
FL
Enumeration date
05/11/2006
Last updated
08/11/2010
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