NPI 1215227202

Jacob Paulk, CRNA

Practitioner Certified Registered Nurse Anesthetist Tifton, GA

Practice location

Address: 901 18th St E, Tifton, GA 31794-3648
Phone: (229) 353-6124
Fax: (229) 353-7722
Mailing address: 209 Tillman Paulk Rd, Ambrose, GA 31512-3486

Registered specialties

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence RN181759 (GA)

Other Nurse Anesthetist, Certified Registered providers in Georgia →

Registry record

NPI: 1215227202
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Apr 2011
Record last updated: 16 Dec 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.