Paul H. Tullis, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS019014 Issued in PA

Practice address

400 College Dr Ste 200
Middleburg, FL 32068-8525

Phone

(904) 213-2700

NPI assigned

Aug 2, 2013

Last updated

May 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1285066126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 CALMING WATER DR UNIT 2606",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320033470",
            "telephone_number": "865-332-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COLLEGE DR STE 200",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688525",
            "telephone_number": "904-213-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLIS",
        "first_name": "PAUL",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-02",
        "last_updated": "2021-05-19",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS019014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCBH",
            "identifier": "14646411",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Middleburg, FL
• Providers in Middleburg, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.