Provider Demographics
NPI:1841592250
Name:TULL, JOHN WOODRING (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WOODRING
Last Name:TULL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 SPRINGDALE ROAD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3723
Mailing Address - Country:US
Mailing Address - Phone:717-843-6836
Mailing Address - Fax:
Practice Address - Street 1:143 SPRINGDALE ROAD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3723
Practice Address - Country:US
Practice Address - Phone:717-843-6836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD009640E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C30894Medicare UPIN