| David J Faulk Md | |
|
1606 Gloucester St Brunswick GA 31520-7145 | |
| (912) 265-7382 | |
| (912) 265-7383 |
| Full Name | David J Faulk Md |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1606 Gloucester St, Brunswick, Georgia |
| Authorized Official Name and Position | David J Faulk (OWNER) |
| Authorized Official Contact | 9122657382 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David J Faulk Md 118 Arthur J Moore Dr St Simons Island GA 31522-2238 Ph: (912) 265-0644 | David J Faulk Md 1606 Gloucester St Brunswick GA 31520-7145 Ph: (912) 265-7382 |
| NPI Number | 1770596256 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 02/08/2021 |
| Certification Date | 02/08/2021 |
| Medicare PECOS PAC ID | 2668464082 |
|---|---|
| Medicare Enrollment ID | O20040402000941 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770596256 | NPI | - | NPPES |
| 000659117D | Medicaid | GA | |
| 000659117A | Medicaid | GA | |
| 000659117C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 039787 (Georgia) | Primary |
| Provider Name | Michael E Daly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659748077 PECOS PAC ID: 7012226822 Enrollment ID: I20151019000642 |
| Provider Name | Amanda Rebecca Mcnulty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851710685 PECOS PAC ID: 4587954656 Enrollment ID: I20160601001815 |
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