MR. EDDIE LYNN PAULK (NPI# 1003813601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003813601 |
| Entity Type | Individual |
| Full Name | MR. EDDIE LYNN PAULK |
| Credential | D.O. |
| Practice Address |
2090 Vadalabene Drive Springfield IL 62062 |
| Mailing Address |
6810 State Route 162 Box 215 Maryville IL 62062-8501 |
| Practice Telephone | 6182885403 |
| Practice Fax Number | 6182886857 |
| Mailing Telephone | 6183916405 |
| Mailing Fax Number | 6182884088 |
| Enumeration Date | 2005-06-29 |
| Last Update Date | 2020-04-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | R9H10 | MO | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | R9H10 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 242830743 | 05 |
| Street Address |
2090 VADALABENE DRIVE |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
| 1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
| 1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
| 1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
| 1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
| 1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
| 1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
| Find all providers in zip 62062 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639675077 | Anand Kanjolia, M.d. LLC | Internal Medicine | 222 Carew St Fl 4, Springfield, MA 01104-4109 | 2018-04-04 |
| 1376068817 | Personal Primary Care and Weight Management, LLC | Internal Medicine | 299 Carew St Ste 234, Springfield, MA 01104-2368 | 2017-08-05 |
| 1184145682 | Basma Al-bast | Internal Medicine | 701 N 1st St Ste 434, Springfield, IL 62702-3757 | 2017-07-05 |
| 1689124604 | John Duff | Internal Medicine | 2909 S Camber Ave, Springfield, MO 65809-3547 | 2016-10-13 |
| 1669834941 | Siddhi Joshi | Internal Medicine | 5501 Backlick Rd Ste 105, Springfield, VA 22151-3940 | 2016-03-24 |
| 1265898936 | Mohammad Rahimuddin | Internal Medicine | 2556 Snyder Domer Rd, Springfield, OH 45502-8161 | 2016-01-11 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1033589304 | Hshs Medical Group Inc | Internal Medicine | 3215 Executive Park Dr, Springfield, IL 62703-4514 | 2015-09-30 |
| 1679992895 | Ahlam Elbadri | Internal Medicine | 2115 S Fremont Ave Ste 2300, Springfield, MO 65804-2233 | 2014-04-15 |
| 1528487543 | Barbara Vinci | Internal Medicine | 2443 Troy Rd, Springfield, OH 45504-4233 | 2014-04-08 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62062 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.