Jack E Paulk, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME34723 Issued in FL

Practice address

1901 SE 18TH Ave
BLDG 300
Ocala, FL 34471-8215

Phone

(352) 351-1313

Fax

(352) 351-1927

NPI assigned

May 11, 2006

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1700836525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12109 CR 103",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344842967",
            "telephone_number": "352-391-6494",
            "fax_number": "352-391-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 SE 18TH AVE",
            "address_2": "BLDG 300",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344718215",
            "telephone_number": "352-351-1313",
            "fax_number": "352-351-1927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULK",
        "first_name": "JACK",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME34723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067419200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "55112",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Patton
• Paul E Anderson, OD, PA
• Paul Pimentel DDS Holdings, PLLC (Aspen Dental)
• Paul Urban MD PA
• Nanette Paul, MA
• Janna Paulk
• Jessica Paus, RN, BSN
• Patricia Sue Payette, CRNA
• Matthew C Payne, SLP
• Pamela H Payne, PTA

• Urology Physician in Ocala, FL
• Providers in Ocala, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.