Provider Demographics
NPI:1962617639
Name:TRULUCK, WILLIAM RAY (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RAY
Last Name:TRULUCK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1841 NEWMAN RD
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-1122
Mailing Address - Country:US
Mailing Address - Phone:517-908-3360
Mailing Address - Fax:517-908-3368
Practice Address - Street 1:1841 NEWMAN RD
Practice Address - Street 2:SUITE
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-1122
Practice Address - Country:US
Practice Address - Phone:517-908-3360
Practice Address - Fax:517-908-3368
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI015368207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMMedicare PIN