Organization
M. MICHAEL PULLIAM, M.D., P.C.
Active
Other names
Pulliam Eye Group/Newton Rockdale ASC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MORRIS MICHAEL PULLIAM M.D. (OWNER/MEDICAL DIRECTOR)
(770) 786-1234
Entity
Organization
Contact information
Practice address
1467 HOSPITAL DRIVE, COVINGTON, GA 30014-2565
(770) 786-1234
(770) 385-0813
Mailing address
P.O. BOX 469, COVINGTON, GA 30015-0469
(770) 786-1234
(770) 385-0813
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11036
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00012229D
—
GA
05
—
00164469I
—
GA
05
—
00164469J
—
GA
05
—
00164469K
—
GA
05
—
00420802A
—
GA
Enumeration date
02/12/2007
Last updated
05/09/2011
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