Individual
DR. PETER PAUL BULLOCK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12301 S WESTERN AVE, OKLAHOMA CITY, OK 73170-6084
(405) 254-7529
(405) 254-7587
Mailing address
601 S HARBOUR ISLAND BLVD STE 200, TAMPA, FL 33602-5925
(727) 322-3439
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25803
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25803
OKLAHOMA MEDICAL LICENSE
OK
Enumeration date
07/23/2008
Last updated
06/02/2026
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