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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982660049 | NPPES |
| Florida | MEDICAID | 264537800 | |
| Florida | MEDICAID | 264536000 |
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