Individual
DR. JUDD T PULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 E GRANT ST, APPLETON, WI 54911-3483
(920) 831-5050
(920) 738-6400
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3200
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11073
MT
207Q00000X
Family Medicine Physician
Primary
48143-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
450030703
MEDICARE PTAN
WI
01
—
711290101
MEDICARE PTAN
WI
Enumeration date
06/21/2006
Last updated
03/15/2012
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