Healthcare Provider Details

I. General information

NPI: 1952301343
Provider Name (Legal Business Name): THOMAS A PULLIG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4419 N HIGHWAY 7 STE 200
HOT SPRINGS VILLAGE AR
71909-9301
US

IV. Provider business mailing address

PO BOX 21850
HOT SPRINGS AR
71903-1850
US

V. Phone/Fax

Practice location:
  • Phone: 501-922-2217
  • Fax: 501-922-4216
Mailing address:
  • Phone: 501-922-2217
  • Fax: 501-922-4216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC4522
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: