IndividualActive
Brandon Tullis, M.D.
NPI 1184050601 · Sports Medicine (Internal Medicine) Physician · Park City, UT
Provider details
- NPI number
- 1184050601
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 5980963-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3850 Canyons Resort Drive
Park City, UT 84098-6546
Phone: (435) 645-4130
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 27128
Salt Lake City, UT 84127-0128
Registry dates
- Enumerated
- 2013-09-16
- Last updated
- 2022-08-03
- Certified
- 2022-07-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.