Michael Tulloch MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

175113 Issued in NY

Legal business name

MICHAEL TULLOCH MD LLC

Practice address

6603 State Highway 56
Potsdam, NY 13676-3510

Phone

(315) 265-4772

Fax

(315) 261-4469

NPI assigned

Mar 20, 2015

Organization subpart

No

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

Authorized official

Name

Michael Joseph Tulloch, M.D.

Title

Sole Owner

Phone

(315) 265-4772

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1426809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426809600000",
    "number": "1063806768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6603 STATE HIGHWAY 56",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136763510",
            "telephone_number": "315-265-4772",
            "fax_number": "315-261-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6603 STATE HIGHWAY 56",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136763510",
            "telephone_number": "315-265-4772",
            "fax_number": "315-261-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL TULLOCH MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-20",
        "last_updated": "2015-03-20",
        "status": "A",
        "authorized_official_last_name": "TULLOCH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "315-265-4772",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "175113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Potsdam, NY
• Providers in Potsdam, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.