Healthcare Provider Details

I. General information

NPI: 1063951994
Provider Name (Legal Business Name): HULL HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2017
Last Update Date: 02/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7855 S EMERSON AVE SUITE H
INDIANAPOLIS IN
46237-8668
US

IV. Provider business mailing address

7855 S EMERSON AVE SUITE H
INDIANAPOLIS IN
46237-8668
US

V. Phone/Fax

Practice location:
  • Phone: 317-300-0370
  • Fax: 317-300-0422
Mailing address:
  • Phone: 317-300-0370
  • Fax: 317-300-0422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number010337237A
License Number StateIN

VIII. Authorized Official

Name: DR. KURTIS A HULL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 317-300-0370