Provider Demographics
NPI:1174594071
Name:HULL, DAVID ARDEN (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ARDEN
Last Name:HULL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:USA MEDDAC EVENS ARMY COMMUNITY HOSPITOL
Mailing Address - Street 2:1650 COCHRANE CIRCLE ATTN: CREDENTIALS OFFICE
Mailing Address - City:FT. CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-4604
Mailing Address - Country:US
Mailing Address - Phone:719-526-7844
Mailing Address - Fax:719-526-7984
Practice Address - Street 1:USA MEDDAC EVANS ARMY COMMUNITY HOSPITOL
Practice Address - Street 2:ROBINSON CLINIC
Practice Address - City:FT. CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4604
Practice Address - Country:US
Practice Address - Phone:719-526-7764
Practice Address - Fax:719-524-2258
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2019-02-15
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Provider Licenses
StateLicense IDTaxonomies
MO35407207Q00000X
IA01566207Q00000X
CO0046223207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAD46467Medicare UPIN