Individual
DR. PAUL E BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1441 ANDERSON AVENUE, MANHATTAN, KS 66502-4072
(785) 776-9461
(785) 776-9946
Mailing address
1441 ANDERSON AVENUE, MANHATTAN, KS 66502-4072
(785) 776-9461
(785) 776-9946
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
912-3
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
912-3
STATE LICENSE NUMBER
KS
Enumeration date
10/03/2006
Last updated
07/08/2007
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