1144280355 NPI number — JANET RUTH TULL M.D.

Table of content: JANET RUTH TULL M.D. (NPI 1144280355)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144280355 NPI number — JANET RUTH TULL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TULL
Provider First Name:
JANET
Provider Middle Name:
RUTH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144280355
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
FLOYD COUNTY HOSP DBA FLOYD COUNTY AREA FAMILY PRACT
Provider Second Line Business Mailing Address:
800 11TH ST
Provider Business Mailing Address City Name:
CHARLES CITY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50616
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
641-228-6830
Provider Business Mailing Address Fax Number:
641-257-4336

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1501 S MAIN ST, SUITE 6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLES CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50616-3444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-257-1184
Provider Business Practice Location Address Fax Number:
641-257-0688
Provider Enumeration Date:
03/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  35605 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: I16518 . This is a "MCR B PROVIDER #" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0635045 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0479188 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 05299 . This is a "WELLMARK BLUE CROSS BLUE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: P00263865 GRP DC4130 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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