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General NPI Number Information
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NPI Number | 1376514125
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Entity Type | Individual
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Provider Name | CHRISTOPHER MATTHEW GARRETT PULS MD
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Gender | Male
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 7601 SOUTHCREST PKWY
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City | SOUTHAVEN
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State | MS
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Zip | 38671-4739
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Country | US
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Telephone | 662-772-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 6712 E 108TH ST
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City | TULSA
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State | OK
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Zip | 74133-7122
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Country | US
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Telephone | 918-607-6007
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 32517
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | EMC0004101
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 69858
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 24295
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License Number State | OK
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