| Thili N Kulatilake Md, Pllc | |
|
4721 N 1st Ave Tucson AZ 85718-5610 | |
| (520) 887-0035 | |
| (520) 888-0134 |
| Full Name | Thili N Kulatilake Md, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4721 N 1st Ave, Tucson, Arizona |
| Authorized Official Name and Position | Thili N Kulatilake (PHYSICIAN) |
| Authorized Official Contact | 5208870035 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thili N Kulatilake Md, Pllc 4721 N 1st Ave Tucson AZ 85718-5610 Ph: (520) 887-0035 | Thili N Kulatilake Md, Pllc 4721 N 1st Ave Tucson AZ 85718-5610 Ph: (520) 887-0035 |
| NPI Number | 1255501599 |
|---|---|
| Provider Enumeration Date | 03/03/2008 |
| Last Update Date | 04/18/2008 |
| Medicare PECOS PAC ID | 2264518240 |
|---|---|
| Medicare Enrollment ID | O20080401000322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255501599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 21515 (Arizona) | Primary |
| Provider Name | Thili N Kulatilake |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396846390 PECOS PAC ID: 5890713812 Enrollment ID: I20051108001075 |
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