Provider Demographics
NPI:1801949854
Name:PAWLARCZYK, DOUGLAS JOSEPH (PHD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:JOSEPH
Last Name:PAWLARCZYK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-0284
Mailing Address - Country:US
Mailing Address - Phone:614-395-0736
Mailing Address - Fax:
Practice Address - Street 1:437 HILL RD N
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-1157
Practice Address - Country:US
Practice Address - Phone:614-834-1919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3661103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist