Healthcare Provider Details

I. General information

NPI: 1326061169
Provider Name (Legal Business Name): THOMAS M PULLING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 N E ST STE 300
PENSACOLA FL
32501-6336
US

IV. Provider business mailing address

PO BOX 622047
ORLANDO FL
32862-2047
US

V. Phone/Fax

Practice location:
  • Phone: 850-432-6851
  • Fax: 850-438-6821
Mailing address:
  • Phone: 850-432-6851
  • Fax: 850-438-6821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4874
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4301111364
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME131926
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: