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NPI Code Detail

MEDICARE: DR. CHARLES R LULL MD

MEDICARE:  DR. CHARLES R LULL  MD
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
12085R0202XDiagnostic Radiology PhysicianMD0000007740TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5300067251OTHERTNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1132751OTHERTNFEDERAL BLACK LUNG
23029154OTHERTNBLUE CROSS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
41640237OTHERTNUNITED HEALTHCARE
65001678OTHERTNMEMPHIS MANAGED CARE TLC
7000000118528OTHERTNUNISON HEALTH PLAN

General Provider Information

NPI Number : 1790849180
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES R LULL MD
Provider Business Mailing Address
First Line : 155 WILLOW ST
Second Line :
City : SAVANNAH
State : TN
Zip : 38372-3690
Country : US
Telephone Number : 504-889-0347
Fax Number : 504-779-9741
Provider Business Practice Location Address
First Line : 935 WAYNE RD
Second Line :
City : SAVANNAH
State : TN
Zip : 38372-1937
Country : US
Telephone Number : 504-889-0347
Fax Number : 504-779-9741
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 03/15/2026

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Directions to “ DR. CHARLES R LULL MD” Practice Location

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