Individual
TRAVIS BULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 HOSPITAL DR EMERGENCY MEDICINE M562 DC029.10, COLUMBIA, MO 65212-0001
(573) 884-4400
Mailing address
1 HOSPITAL DR EMERGENCY MEDICINE M562 DC029.10, COLUMBIA, MO 65212-0001
(573) 884-4400
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2020015720
MO
207P00000X
Emergency Medicine Physician
M-17087
ID
Other
Enumeration date
06/19/2020
Last updated
04/26/2023
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