Eddie L Paulk (NPI# 1003813601, PAC ID# 4284618463) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1003813601 |
| PAC ID by PECOS | 4284618463 |
| Professional Enrollment ID | I20171129000036 |
| Full Name | Eddie L Paulk |
| Organization Legal Name | MARYVILLE PHYSICIANS SERVICES LLC |
| Address |
6812 State Rd 162 Suite 204 Maryville IL 62062-8562 |
| Phone Number | 6182882120 |
| Gender | M |
| Credential | DO |
| Medical School | UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES |
| Graduation Year | 1986 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 5193792018 |
| Number of Group Practice Members | 66 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140289 | ANDERSON HOSPITAL |
| 140125 | GATEWAY REGIONAL MEDICAL CENTER |
| 140002 | ALTON MEMORIAL HOSPITAL |
| 141336 | ST JOSEPH'S HOSPITAL |
| 141306 | COMMUNITY MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 6812 State Rd 162, Suite 204, Maryville, IL 62062-8562 | 6182882120 | MARYVILLE PHYSICIANS SERVICES LLC |
| Organization Legal Name | MARYVILLE PHYSICIANS SERVICES LLC |
| Physicians | 66 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jamie M Schneider | Nurse Practitioner | Maryville Physicians Services LLC | 20 Professional Park Dr B, Maryville, IL 62062-5830 |
| Kelsy B Wasmuth | Nurse Practitioner | Maryville Physicians Services LLC | 6810 State Route 162, Maryville, IL 62062-8501 |
| Jennifer M Oyler | Physician Assistant | Maryville Physicians Services LLC | 6812 State Route 162 120, Maryville, IL 62062-8553 |
| Josephine La Glaser | Family Medicine | Maryville Physicians Services LLC | 6616 Ctr Grove Rd, Edwardsville, IL 62025-2802 |
| Alyssa M Ruwe | Nurse Practitioner | Maryville Physicians Services LLC | 6812 State Route 162 123, Maryville, IL 62062-8586 |
| Ashley R Noeth | Nurse Practitioner | Maryville Physicians Services LLC | 4956 Autumn Oaks Dr, Maryville, IL 62062-8559 |
| Jessica E Henke | Nurse Practitioner | Maryville Physicians Services LLC | 6812 State Route 162 20, Maryville, IL 62062-8553 |
| Alan M Meredith | Physician Assistant | Maryville Physicians Services LLC | 6810 State Route 162 203, Maryville, IL 62062-8566 |
| Laura S Bird | Family Medicine | Maryville Physicians Services LLC | 2704 N Ctr St, Maryville, IL 62062-5624 |
| Tibor C Kopjas | Internal Medicine | Maryville Physicians Services LLC | 2118 Vadalabene Dr, Maryville, IL 62062-5632 |
| Street Address |
6812 STATE RD 162 SUITE 204 |
| City | MARYVILLE |
| State | IL |
| Zip | 62062-8562 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James J Dalla Riva | Obstetrics/gynecology | James J Dalla Riva Md PC | 6812 State Rd 162, Suite 301, Maryville, IL 62062 |
| Bryson Thomas Whalen | Obstetrics/gynecology | James J Dalla Riva Md PC | 6812 State Rd 162, Suite 301, Maryville, IL 62062 |
| Thomas M Hulsen | Obstetrics/gynecology | James J Dalla Riva Md PC | 6812 State Rd 162, Suite 301, Maryville, IL 62062 |
| Angela Marie Lytle | Nurse Practitioner | Maryville Physicians Services LLC | 6812 State Rd 162, Suite 204, Maryville, IL 62062-8562 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shubhangi S Peche | Neurology | St Louis University | 2133 Vadabalene, Maryville, IL 62062 |
| David W Kinscherff | Podiatry | Foot Health Center Inc P C | 122 E Zupan St, Maryville, IL 62062-2010 |
| Krystal Gilb | Nurse Practitioner | Hshs Medical Group Inc | 2401 S Ctr St, Maryville, IL 62062-5401 |
| Zachary Paul Luchtefeld | Family Medicine | Hshs Medical Group Inc | 2401 S Ctr St, Maryville, IL 62062-5401 |
| Amanda J Kilzer | Nurse Practitioner | Hshs Medical Group Inc | 2401 S Ctr St, Maryville, IL 62062-5401 |
| Robert T Farmer | Family Medicine | Hshs Medical Group Inc | 2401 S Ctr St, Maryville, IL 62062-5401 |
| Holly Harlow Shirley | Nurse Practitioner | Hshs Medical Group Inc | 2401 S Ctr St, Maryville, IL 62062-5401 |
| Paul G Malcharek | Internal Medicine | Hshs Medical Group Inc | 2401 S Ctr St, Maryville, IL 62062-5401 |
| Bryan W Reid | Chiropractic | 2805 N Ctr, Maryville, IL 62062-5622 | |
| Kristin Elizabeth Nobbe | Chiropractic | 2805 N Ctr, Maryville, IL 62062-5622 | |
| Find all physicians in zip 62062 | |||
| City | MARYVILLE |
| Zip Code | 62062 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | MARYVILLE + INTERNAL MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.