Individual
DR. MICHAEL THOMAS PULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
580 W 8TH ST, UFJP NEUROLOGY, JACKSONVILLE, FL 32209-6533
(904) 244-3960
(904) 244-3425
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME80022
FL
2084N0600X
Clinical Neurophysiology Physician
ME80022
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000801215A
—
GA
01
—
130018141
RAILROAD MEDICARE
FL
05
—
2541190-00
—
FL
Enumeration date
03/14/2006
Last updated
06/12/2009
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