Provider Demographics
NPI:1952366643
Name:TULEY, WILLIAM JAY (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JAY
Last Name:TULEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 PROFESSIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-8002
Mailing Address - Country:US
Mailing Address - Phone:812-479-9500
Mailing Address - Fax:812-437-0037
Practice Address - Street 1:1200 PROFESSIONAL BLVD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-8002
Practice Address - Country:US
Practice Address - Phone:812-479-9500
Practice Address - Fax:812-437-0037
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01032032207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INB29660Medicare UPIN