Tully, Thomas W

Tully, Thomas W is an sole proprietor health care provider with primary practice located at 615 N Bonita Ave , Panama City FL 32401-3623. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Tully, Thomas W can be contacted via phone (850) 747-6000.

Contact Information

Primary practice address
615 N Bonita Ave Panama City FL 32401-3623
Phone: (850) 747-6000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD00033876 Washington
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 102657 Florida
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 42410-20 Wisconsin

Profile Details

NPI number 1851369664
LBN Legal business name Tully, Thomas W
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 8th, 2006
Last updated Mar 26th, 2015 - about 10 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 1851369664 NPPES
Washington MEDICAID 8195596
Washington Other M18541
Washington Other 930103921

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