Tanner R. Bulkley, PA-C
Physician Assistant in Troy, PA. Individual provider (NPI-1).
NPI number1104336742
StatusActive
Last updated in NPPESJul 14, 2023
Details
- NPI
- 1104336742
- Entity type
- Individual (NPI-1)
- Name
- Tanner R. Bulkley
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 10, 2017
- Certification date
- Jul 14, 2023
- Last updated
- Jul 14, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | MA059314 | PA | Yes |
Practice location
45 Mud Creek RdTroy, PA 16947-9529
Phone 570-297-3746
Mailing address
40 W Wellsboro StMansfield, PA 16933-1411
Phone 570-662-1945
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Physician Assistant providers in Troy, PA
- Amanda Albright Blasz, PANPI 1720015456
- Courtney Case, PA-CNPI 1831979236
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- Dylan Michael Saxon, PANPI 1871062083
All 5 Physician Assistant providers in Troy · All 140 providers in Troy
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