Individual
JOHN OWEN TULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7580 NORTHCLIFF AVE STE 1000, BROOKLYN, OH 44144-3271
(440) 808-1212
(440) 808-0321
Mailing address
850 COLUMBIA RD, STE 200, WESTLAKE, OH 44145-7215
(216) 767-5664
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35.097547
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050898
—
OH
01
—
P00992476
MEDICARE RAILROAD
OH
Enumeration date
01/24/2008
Last updated
01/19/2024
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