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Organization
TOM WULF MD LLC
Active
Organization
TOM WULF MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS WULF MD (OWNER)
(575) 208-7795
Entity
Organization
Contact information
Practice address
607 W COUNTRY CLUB RD, ROSWELL, NM 88201-5211
(575) 208-7795
(575) 208-7785
Mailing address
313 W COUNTRY CLUB RD STE 15, ROSWELL, NM 88201-5804
(575) 208-7795
(575) 208-7785
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
251G00000X
Community Based Hospice Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42637716
—
NM
Enumeration date
02/10/2020
Last updated
05/11/2020
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