Healthcare Provider Details

I. General information

NPI: 1679008767
Provider Name (Legal Business Name): RECHELLE TULL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2017
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2741 DEBARR RD STE 215
ANCHORAGE AK
99508-2978
US

IV. Provider business mailing address

1120 HUFFMAN RD STE 24-401
ANCHORAGE AK
99515-3516
US

V. Phone/Fax

Practice location:
  • Phone: 907-865-8455
  • Fax:
Mailing address:
  • Phone: 434-847-6132
  • Fax: 434-845-4870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number208167
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number208167
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: