Individual
DR. JACK KEVIN BULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-1616
Mailing address
510 W WASHINGTON AVE APT 508, MADISON, WI 53703-2993
(715) 768-0545
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R-13133
IA
Other
Enumeration date
05/15/2024
Last updated
05/15/2024
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