Individual
DR. JEFFREY KENNETH CHAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
207W00000X
Ophthalmology Physician
Primary
4301405077
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0585020001
ADMINASTAR FEDERAL
MA
01
—
0F94502001
MEDICARE PLUS BLUE
MI
01
—
180012703
RAILROAD MEDICARE
MI
01
—
1806920011
BCBS
MI
05
—
3038315
—
MI
Enumeration date
06/04/2006
Last updated
12/15/2022
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