Provider Demographics
NPI:1144280355
Name:TULL, JANET RUTH (MD)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:RUTH
Last Name:TULL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:FLOYD COUNTY HOSP DBA FLOYD COUNTY AREA FAMILY PRACT
Mailing Address - Street 2:800 11TH ST
Mailing Address - City:CHARLES CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50616
Mailing Address - Country:US
Mailing Address - Phone:641-228-6830
Mailing Address - Fax:641-257-4336
Practice Address - Street 1:1501 S MAIN ST, SUITE 6
Practice Address - Street 2:
Practice Address - City:CHARLES CITY
Practice Address - State:IA
Practice Address - Zip Code:50616-3444
Practice Address - Country:US
Practice Address - Phone:641-257-1184
Practice Address - Fax:641-257-0688
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA35605207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI16518OtherMCR B PROVIDER #
IA0635045Medicaid
IA0479188Medicaid
IA05299OtherWELLMARK BLUE CROSS BLUE
IAP00263865 GRP DC4130OtherRAILROAD MEDICARE
IAI16518OtherMCR B PROVIDER #