Individual
GRANT C. BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-9608
(319) 384-9613
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-9608
(319) 384-9613
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
0101239483
VA
207ZH0000X
Hematology (Pathology) Physician
MD-50747
IA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
MD-50747
IA
Other
Enumeration date
06/30/2009
Last updated
03/02/2023
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