Individual
DR. JEFFREY KENNETH CHAULK
Active
Individual
DR. JEFFREY KENNETH CHAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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