Provider Demographics
NPI:1902810575
Name:DULL, WILLIAM LISTER (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LISTER
Last Name:DULL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:321 E MARKET ST
Mailing Address - Street 2:STE 106
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-2176
Mailing Address - Country:US
Mailing Address - Phone:319-351-1860
Mailing Address - Fax:319-351-4470
Practice Address - Street 1:321 E MARKET ST
Practice Address - Street 2:STE 106
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2176
Practice Address - Country:US
Practice Address - Phone:319-351-1860
Practice Address - Fax:319-351-4470
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA18978207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0140020Medicaid
IAA02037Medicare UPIN
IA19744001Medicare PIN