Justin F Thulin, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

3259971205 Issued in UT

Practice address

1151 E 3900 S
Parkview Building B 259
Salt Lake City, UT 84124-1216

Phone

(801) 266-7325

Fax

(801) 281-2263

NPI assigned

Jun 5, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1023057098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 E 3900 S",
            "address_2": "STE B259",
            "city": "SALT LAKE CTY",
            "state": "UT",
            "postal_code": "841241259",
            "telephone_number": "801-266-7325",
            "fax_number": "801-281-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 E 3900 S",
            "address_2": "PARKVIEW BUILDING B 259",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241216",
            "telephone_number": "801-266-7325",
            "fax_number": "801-281-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THULIN",
        "first_name": "JUSTIN",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "3259971205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID NUMBER",
            "identifier": "9311824424",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thrive Bright ABA Ut LLC
• Thrive on
• Thrivewave LLC
• Steven Kyle Throneberry, M.D.
• John Darrell Thueson, M.D.
• Perla Cassayre Thulin, MD
• Daniel Heiner Thunell, DMD
• Abbie Ranae Thurgood, CSW
• Randy F Thurgood
• Tian Tian

• Dermatology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.