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Organization

WILLIAM J BULKLEY M D P A

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM JENNISON BULKLEY M.D. (PHYSICAN - OWNER)
(870) 240-8020
Entity
Organization

Contact information

Practice address
1000 W KINGSHIGHWAY, STE # 3, PARAGOULD, AR 72450-4141
(870) 240-8020
(870) 240-8028
Mailing address
PO BOX 579, PARAGOULD, AR 72451-0579
(870) 240-8020
(870) 240-8028

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
207Y00000X
Otolaryngology Physician
207YS0012X
Sleep Medicine (Otolaryngology) Physician
207YX0602X
Otolaryngic Allergy Physician
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
208600000X
Surgery Physician
2086S0122X
Plastic and Reconstructive Surgery Physician
231H00000X
Audiologist
A417
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
131753002
AR
Enumeration date
02/01/2007
Last updated
10/30/2017
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