Active NPI
Wilson Guinn Paulk, M.D.
- Ophthalmology Physician
- Montgomery, AL
National Provider Identifier
1295771509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 16479
- Practice address
- 262 Mitylene Park Dr
Montgomery, AL 36117-3548 - Phone
- (334) 260-8511
- Fax
- (334) 260-8755
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 16479 | AL | Primary |
Addresses
Primary practice location
262 Mitylene Park Dr
Montgomery, AL 36117-3548
Mailing address
262 Mitylene Park Dr
Montgomery, AL 36117-3548
Phone (334) 260-8511
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051519733 | Medicaid | AL | |
| 51520076 | Other | AL | BLUE CROSS BLUE SHIELD |
Other names 1
- Dr. W Guinn Paulk
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16479 | AL | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| S. Douglas Owens, M.D., P.C. | Past | Accepting new patients |
Interoperability endpoints
- w.paulk@direct.baptistfirst.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Montgomery, AL
- NPI 1841235181
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357776000000",
"number": "1295771509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "262 MITYLENE PARK DR",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361173548",
"telephone_number": "334-260-8511",
"fax_number": "334-260-8755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "262 MITYLENE PARK DR",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361173548",
"telephone_number": "334-260-8511",
"fax_number": "334-260-8755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULK",
"first_name": "WILSON",
"middle_name": "GUINN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2013-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "AL",
"license": "16479",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "051519733",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "51520076",
"state": "AL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "W",
"last_name": "PAULK",
"middle_name": "GUINN",
"prefix": "DR.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.