Provider Demographics
NPI:1245283134
Name:TED J PULS MD PC
Entity type:Organization
Organization Name:TED J PULS MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:TED
Authorized Official - Middle Name:J
Authorized Official - Last Name:PULS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-561-4336
Mailing Address - Street 1:1619 N GREENWOOD ST STE 208
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-2656
Mailing Address - Country:US
Mailing Address - Phone:719-561-4336
Mailing Address - Fax:719-561-8469
Practice Address - Street 1:1619 N GREENWOOD ST STE 208
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2656
Practice Address - Country:US
Practice Address - Phone:719-561-4336
Practice Address - Fax:719-561-8469
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TED J PULS MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-19
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCN0008Medicare PIN