Individual
KATHLEEN W PAULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
63 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1825
(479) 582-3366
(479) 582-5843
Mailing address
PO BOX 8158, FAYETTEVILLE, AR 72703-0003
(479) 582-3366
(479) 582-5843
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
E-2446
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140580001
—
AR
01
—
5L405
AR BC/BS
AR
01
—
P00315084
RR MCR
AR
Enumeration date
06/30/2006
Last updated
12/08/2011
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