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General NPI Number Information
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NPI Number | 1457554750
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Entity Type | Organization
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Legal Business Name | TULLIO EMANUELE MD, PSC
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 09/11/2008
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Provider Practice Location Address
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Address Line | 720 SECOND STREET SUITE 204
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City | BOWLING GREEN
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State | KY
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Zip | 42101-5852
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Country | US
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Telephone | 270-782-6964
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Fax | 270-782-6988
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Provider Business Mailing Address
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Address Line | 720 SECOND STREET SUITE 204
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City | BOWLING GREEN
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State | KY
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Zip | 42101-5852
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Country | US
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Telephone | 270-782-6964
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Fax | 270-782-6988
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Authorized Official
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Title or Position | PRESIDENT
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Name | TULLIO EMANUELE
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Credential | M.D.
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Telephone | 270-782-6964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 39597
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License Number State | KY
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