MEDICARE: DAN W PULSIPHER DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	044062	GA
2	207Q00000X	Family Medicine Physician	OS9454	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03540	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194721019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAN W PULSIPHER DO

Provider Business Mailing Address
First Line	:	2995 DREW ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-3012
Country	:	US
Telephone Number	:	727-315-7496
Fax Number	:

Provider Business Practice Location Address
First Line	:	5089 LITTLE RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-1326
Country	:	US
Telephone Number	:	727-375-7929
Fax Number	:	813-635-2634

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	06/13/2024

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Directions to “ DAN W PULSIPHER DO” Practice Location

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