Tally, Philip W

Tally, Philip W is an individual health care provider with primary practice located at 200 3Rd Ave W Suite 200, Bradenton FL 34205-8626. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurological Surgery, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Neurological Surgery is his primary health care specialty. Tally, Philip W can be contacted via phone (941) 794-3118.

Contact Information

Primary practice address
200 3Rd Ave W Suite 200 Bradenton FL 34205-8626
Phone: (941) 794-3118
Fax: (941) 782-2017
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X ME53442 Florida
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME53442 Florida
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X ME53442 Florida

Profile Details

NPI number 1982660049
LBN Legal business name Tally, Philip W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Apr 23rd, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982660049 NPPES
Florida MEDICAID 264537800
Florida MEDICAID 264536000

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