Provider Demographics
NPI:1942499611
Name:PAULICK, JOSHUA ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ALAN
Last Name:PAULICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3932 LEONORA DR
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45420-1239
Mailing Address - Country:US
Mailing Address - Phone:937-776-2256
Mailing Address - Fax:
Practice Address - Street 1:100 CLARK CT
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-9395
Practice Address - Country:US
Practice Address - Phone:937-776-2256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.013263208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery