Thomas S Mullally (NPI# 1629030879, PAC ID# 0446417778) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1629030879 |
| PAC ID by PECOS | 0446417778 |
| Professional Enrollment ID | I20120130000092 |
| Full Name | Thomas S Mullally |
| Address |
5525 Peck Rd Croswell MI 48422-9108 |
| Phone Number | 8106792950 |
| Gender | M |
| Medical School | WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1987 |
| Primary Specialty | FAMILY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230031 | LAKE HURON MEDICAL CENTER |
| 230216 | MCLAREN PORT HURON |
| 231314 | MCKENZIE HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 5525 Peck Rd, Croswell, MI 48422-9108 | 8106792950 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Street Address |
5525 PECK RD |
| City | CROSWELL |
| State | MI |
| Zip | 48422-9108 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Loretta Mullally | General Practice | 5525 Peck Rd, Croswell, MI 48422-9108 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jonathan S Del Rosario | Physical Therapy | Croswell Manual Therapy Inc. | 51 Brown St, Suite 5, Croswell, MI 48422-1159 |
| Donna M Grundman | Physical Therapy | Croswell Manual Therapy Inc. | 51 Brown St, Suite 5, Croswell, MI 48422-1159 |
| Kimberley A Curell | Physician Assistant | Mckenzie Memorial Hospital | 8 N Howard Ave, Croswell, MI 48422-1221 |
| Matthew D Gormley | Internal Medicine | Mckenzie Memorial Hospital | 8 N Howard Ave, Croswell, MI 48422-1221 |
| Philip S Rutherford | Chiropractic | 31 N Howard Ave, Croswell, MI 48422-1222 | |
| Jerry J Hosterman | Clinical Social Worker | 81 N Howard Ave, Croswell, MI 48422-1222 | |
| Gloria Klinesteker | Clinical Social Worker | Sanilac County Community Mental Health Authority | 110 N Howard Ave, Croswell, MI 48422-1256 |
| Jodie L-k Jones | Clinical Social Worker | 112 N Howard Ave, Croswell, MI 48422-1278 |
| City | CROSWELL |
| Zip Code | 48422 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | CROSWELL + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Thomas S Mullally.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.