Tullis, Michael J.

Tullis, Michael J. is an individual health care provider with primary practice located at 3875 E Overland Rd Ste 2D , Meridian ID 83642-9005. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Tullis, Michael J. can be contacted via phone (208) 600-1550.

Contact Information

Primary practice address
3875 E Overland Rd Ste 2D Meridian ID 83642-9005
Phone: (208) 600-1550
Fax: (208) 600-1551
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X M-7939 Idaho

Profile Details

NPI number 1598717985
LBN Legal business name Tullis, Michael J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Oct 9th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598717985 NPPES
Oregon MEDICAID 288349
Oregon Other 000010028313
Oregon MEDICAID 805714900
Oregon Other J3938
Oregon Other 770002414

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