Individual
TULLY STEPHEN ROISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1151 HAL GREER BLVD, HUNTINGTON, WV 25701-3705
(304) 529-2800
(304) 529-2802
Mailing address
1151 HAL GREER BLVD, HUNTINGTON, WV 25701-3705
(304) 529-2800
(304) 529-2802
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
12735
WV
207W00000X
Ophthalmology Physician
23615
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0096811000
—
WV
05
—
64695562
—
KY
Enumeration date
06/25/2006
Last updated
09/29/2010
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