Individual
TRACY PULLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 HOSPITAL DRIVE SE, CRESTWOOD HOSPITAL, HUNTSVILLE, AL 35801
(256) 429-5196
(256) 429-4573
Mailing address
PO BOX 1814, MADISON, AL 35758-5410
(256) 429-5196
(256) 429-4573
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26489
AL
208M00000X
Hospitalist Physician
26489
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051558692
—
AL
05
—
109222
—
AL
01
—
510I110424
MEDICARE
AL
01
—
515-97252
BCBS OF ALABAMA
AL
01
—
51539247
BCBS OF ALABAMA
AL
Enumeration date
03/02/2007
Last updated
11/23/2010
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