Paul Thomas Foulk, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS027873L Issued in PA

Practice address

155 N 3Rd St
Conneaut Lake, PA 16316

Phone

(814) 382-5100

Fax

(814) 382-5100

NPI assigned

Nov 21, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275516619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 492",
            "address_2": "155 N 3RD ST",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "163160492",
            "telephone_number": "814-382-5100",
            "fax_number": "814-382-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N 3RD ST",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "16316",
            "telephone_number": "814-382-5100",
            "fax_number": "814-382-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOULK",
        "first_name": "PAUL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS027873L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012612260001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDPLUS",
            "identifier": "66691",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC FOR U",
            "identifier": "10298",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Conneaut Lake Chiropractic, PC
• Conneaut Valley Health Center Inc.
• Mindy Curtiss, CERT HEALTH COACH
• Ryan Scott Evans, D.O.
• Carrie Elizabeth Flemming
• Thomas Carl Fox, DMD
• Thomas Gilbert, PT, DPT
• Hannah Gill, CRNP
• Kelsey Greathouse, MA, CCC-SLP
• Deborah Jean Gregg, MA LICENSED PSYCHOLO

• General Practice Dentistry in Conneaut Lake, PA
• Providers in Conneaut Lake, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.