DR. ANDREW RICHARD PULLIAM (NPI# 1134160120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134160120 |
Entity Type | Individual |
Full Name | DR. ANDREW RICHARD PULLIAM |
Credential | M.D. |
Practice Address |
2490 S Woodworth Loop Suite 201 Palmer AK 99645-7405 |
Practice Telephone | 9077459200 |
Practice Fax Number | 9077459201 |
Mailing Telephone | 9077459200 |
Mailing Fax Number | 9077459201 |
Enumeration Date | 2006-06-09 |
Last Update Date | 2013-11-06 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
4516 | AK | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PTAN | K160457 | 01 | |
AK | 1013105 | 05 |
Street Address |
2490 S WOODWORTH LOOP SUITE 201 |
City | PALMER |
State | AK |
Zip Code | 99645-7405 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366443871 | Michael R Senta | Surgery | 2490 S Woodworth Loop, Suite 450, Palmer, AK 99645-7405 | 2005-08-09 |
1487017877 | Megan Ferguson | Advanced Practice Midwife | 2490 S Woodworth Loop, Suite 301, Palmer, AK 99645-7410 | 2016-04-01 |
1770967598 | Midnight Sun Oncology Partners, LLC | Internal Medicine | 2490 S Woodworth Loop, Suite 499, Palmer, AK 99645-7410 | 2015-07-10 |
1568861086 | Glacier Surgical Associates, Inc | Surgery | 2490 S Woodworth Loop, Suite 450, Palmer, AK 99645-7410 | 2014-08-20 |
1972842326 | Brianna Nye | Physician Assistant | 2490 S Woodworth Loop, Suite 350, Palmer, AK 99645-7405 | 2013-02-05 |
1508129628 | Cellnetix Pathology, Pllc | Pathology | 2490 S Woodworth Loop, Suite 410, Palmer, AK 99645-7405 | 2012-06-22 |
1538422639 | Cellnetix Labs, LLC | Clinical Medical Laboratory | 2490 S Woodworth Loop, Palmer, AK 99645-7405 | 2012-06-22 |
1861776791 | Mat-su Plastic Surgery LLC | Plastic Surgery | 2490 S Woodworth Loop, Suite 310, Palmer, AK 99645-7405 | 2011-10-11 |
1245538396 | Sarah Wood Johanson | Nurse Practitioner | 2490 S Woodworth Loop, Suite 450, Palmer, AK 99645-7410 | 2011-03-14 |
1447570874 | Valley Radiation Oncology | Radiology | 2490 S Woodworth Loop, Suite 150, Palmer, AK 99645-7405 | 2010-06-08 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295357135 | Kasey M Flintoft | Occupational Therapist | 7200 E. Jim Cottrell Cir, Palmer, AK 99645 | 2020-05-14 |
1629601471 | Courtney Randol | Licensed Practical Nurse | 14405 E Pace Dr., Palmer, AK 99645 | 2020-02-20 |
1689213092 | Valerie Anne Delaune | Acupuncturist | 9693 N. Little Otter Dr., Palmer, AK 99645 | 2020-01-02 |
1003464512 | Alaskan Sunrise Behavioral Health, L.L.C. | Clinic/Center | 14460 E. Pace Dr., Palmer, AK 99645 | 2019-08-28 |
1548814718 | Maple Springs of Palmer Snf Holdings, LLC | Skilled Nursing Facility | 12130 E Maple Springs Way, Palmer, AK 99645 | 2019-07-26 |
1952868655 | Carla Beth Kelly | Physical Therapist | 7200 Jim Cottrell Circle, Palmer, AK 99645 | 2019-02-28 |
1366938375 | Wendy S Page | Behavior Technician | 7200 E Jim Cottrell, Wasilla, AK 99645 | 2018-07-03 |
1154845170 | Sarah Elizabeth Gilliland | Occupational Therapist | 7200 E Jim Cottrell Circle, Palmer, AK 99645 | 2017-08-01 |
1558885137 | Garland Brooks | Massage Therapist | 1934 Prospect Dr, Palmer, AK 99645 | 2017-07-26 |
1386165009 | Sommer Dawn Nielsen | Massage Therapist | 3566 N Mars Ave., Palmer, AK 99645 | 2017-07-03 |
Find all providers in zip 99645 |
Taxonomy Code | 207YX0905X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
Specialization | Otolaryngology/Facial Plastic Surgery |
An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386739837 | Kevin Neal Jensen | Otolaryngology | 3750 E Country Field Cir Ste B, Wasilla, AK 99654-6659 | 2006-10-03 |
1891894606 | James Victor Zirul | Otolaryngology | 220 Spur View Drive, Kenai, AK 99611-6880 | 2006-09-21 |
1972552891 | Ear, Nose and Throat Specialists Alaska, Inc. | Otolaryngology | 3831 Piper Street Suite#s433, Anchorage, AK 99508 | 2006-05-08 |
1114548351 | Alaska Facial Plastic Surgery & Ent | Otolaryngology | 3719 E Meridian Loop Ste E, Wasilla, AK 99654-7273 | 2020-04-28 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.