Individual
DR. COLLIN LOWELL TULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
146 E HOSPITAL DR STE 400, WEST COLUMBIA, SC 29169-4800
(803) 936-3300
(803) 936-7735
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 936-3300
(803) 936-7735
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
86679
SC
390200000X
Student in an Organized Health Care Education/Training Program
57-022723
OH
Other
Enumeration date
09/23/2013
Last updated
12/20/2022
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