Healthcare Provider Details

I. General information

NPI: 1578535811
Provider Name (Legal Business Name): THOMAS PATRICK HULL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 06/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 GRAHAM RD STE 103
CUYAHOGA FALLS OH
44221-1052
US

IV. Provider business mailing address

650 GRAHAM RD STE 103
CUYAHOGA FALLS OH
44221-1052
US

V. Phone/Fax

Practice location:
  • Phone: 330-434-1185
  • Fax: 330-434-8533
Mailing address:
  • Phone: 330-434-1185
  • Fax: 330-434-8533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number35069159
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35069159H
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: