Individual
CARMEN N. BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O. D.
Contact information
Practice address
2373 E MAIN ST, WAL-MART VISION CENTER, PLAINFIELD, IN 46168-2717
(317) 839-0713
(317) 837-4093
Mailing address
114 KINGSVIEW DR, MOORESVILLE, IN 46158-2734
(317) 839-0713
(317) 837-4093
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002990
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200240510
—
IN
Enumeration date
05/08/2006
Last updated
12/16/2008
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