Basic Information
| Provider Information | |||||||||
| NPI: | 1447249065 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PULK | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 720 S COLORADO BLVD | ||||||||
| Address2: | SUITE 220A | ||||||||
| City: | GLENDALE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802461912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035349550 | ||||||||
| FaxNumber: | 7209327805 | ||||||||
| Practice Location | |||||||||
| Address1: | 1515 WAZEE ST | ||||||||
| Address2: | UNIT D | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802021478 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035349550 | ||||||||
| FaxNumber: | 7209327805 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2005 | ||||||||
| LastUpdateDate: | 06/17/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 23057 | CO | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.