NPIMap

Organization Active NPI

Paulk Chiropractic-Fayettevill Inc.

  • Chiropractor
  • Fayetteville, GA
National Provider Identifier
1508900432
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
GA001074 Issued in GA
Legal business name
PAULK CHIROPRACTIC-FAYETTEVILL INC.
Practice address
155 Bradford SQ
Suite C
Fayetteville, GA 30215-1994
Phone
(770) 719-1917
Fax
(770) 719-1918
NPI assigned
Feb 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. George Phillip Paulk, D.C.NPI 1699870238
Title
Owner
Phone
(770) 719-1917

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X GA001074 GA Primary

Addresses

Primary practice location

155 Bradford SQ
Suite C
Fayetteville, GA 30215-1994

Mailing address

155 Bradford SQ
Suite C
Fayetteville, GA 30215-1994
Phone (770) 719-1917

National Provider Directory

National Provider Directory

Locations

155 Bradford Sq
Ste C
Fayetteville, GA 30215
Phone (770) 719-1917

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508900432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 BRADFORD SQ",
            "address_2": "SUITE C",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302151994",
            "telephone_number": "770-719-1917",
            "fax_number": "770-719-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 BRADFORD SQ",
            "address_2": "SUITE C",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302151994",
            "telephone_number": "770-719-1917",
            "fax_number": "770-719-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULK CHIROPRACTIC-FAYETTEVILL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAULK",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-719-1917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "GA001074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.