Individual
DR. GENE EDWARD TULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 16TH ST, GREELEY, CO 80631-5154
(970) 810-2026
(970) 810-2028
Mailing address
1801 16TH ST, NCMC PULM CLINIC BANNER HEALTH, GREELEY, CO 80631-4500
(970) 810-2026
(970) 810-2028
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
23142
CO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
23142
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01231422
—
CO
01
—
P00134623
RAILROAD MEDICARE
CO
Enumeration date
01/19/2006
Last updated
03/17/2018
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