Paulk, Eddie Lynn

Paulk, Eddie Lynn is an sole proprietor health care provider with primary practice located at 2090 Vadalabene Drive , Springfield IL 62062. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Paulk, Eddie Lynn can be contacted via phone (618) 288-5403.

Contact Information

Primary practice address
2090 Vadalabene Drive Springfield IL 62062
Phone: (618) 288-5403
Fax: (618) 288-6857
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X R9H10 Missouri
Allopathic & Osteopathic Physicians / General Practice 208D00000X R9H10 Missouri

Profile Details

NPI number 1003813601
LBN Legal business name Paulk, Eddie Lynn
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 29th, 2005
Last updated Apr 16th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003813601 NPPES
Missouri MEDICAID 242830743

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