Active NPI
William Christopher Tullock, M.D.
- Anesthesiology Physician
- Venetia, PA
National Provider Identifier
1043349244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD030529E
- Practice address
- 110 Castlebrooke Dr
Venetia, PA 15367-1389 - Phone
- (724) 942-1310
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Neuromusculoskeletal Medicine) Physician | 204C00000X | MD030529E | PA | |
| Anesthesiology Physician | 207L00000X | MD030529E | PA | Primary |
Addresses
Primary practice location
110 Castlebrooke Dr
Venetia, PA 15367-1389
Mailing address
110 Castlebrooke Dr
Venetia, PA 15367-1389
Phone (724) 942-1310
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD030529E | PA | MD | Sports Medicine (Neuromusculoskeletal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456272000000",
"number": "1043349244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 CASTLEBROOKE DR",
"city": "VENETIA",
"state": "PA",
"postal_code": "153671389",
"telephone_number": "724-942-1310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 CASTLEBROOKE DR",
"city": "VENETIA",
"state": "PA",
"postal_code": "153671389",
"telephone_number": "724-942-1310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TULLOCK",
"first_name": "WILLIAM",
"middle_name": "CHRISTOPHER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2016-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "204C00000X",
"taxonomy_group": "",
"desc": "Neuromusculoskeletal Medicine, Sports Medicine",
"state": "PA",
"license": "MD030529E",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "PA",
"license": "MD030529E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Venetia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.