Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | E-11093 | AR |
Y | 111NI0900X | Internist | E-11093 | AR |
NPI | 1003043936 |
---|---|
Provider Name | Lauren Cantwell Paulk |
First Address | Cave Springs, AR 72718-5501 |
Second Address | Fayetteville, AR 72703-5249 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2009 |
Last Update Date | 01/07/2020 |