Individual
DR. THOMAS B KULB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
1401 EASTLAND DR, SUITE B, BLOOMINGTON, IL 61701-3514
(309) 663-9424
(309) 663-6350
Mailing address
1401 EASTLAND DR, SUITE B, BLOOMINGTON, IL 61701-3514
(309) 663-9424
(309) 663-6350
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0723870001
DME PROVIDER NUMBER
IL
01
—
5732045
BC BS PROVIDER NUMBER
IL
Enumeration date
06/29/2006
Last updated
09/13/2007
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