Healthcare Provider Details

I. General information

NPI: 1639309925
Provider Name (Legal Business Name): HANS HUNT TULIP MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 14TH ST
MERIDIAN MS
39301-4041
US

IV. Provider business mailing address

965 RIDGE LAKE BLVD STE 315
MEMPHIS TN
38120-9401
US

V. Phone/Fax

Practice location:
  • Phone: 601-693-3834
  • Fax: 601-693-6275
Mailing address:
  • Phone: 877-348-1281
  • Fax: 901-227-3206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number23002
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: