Individual
DR. THOMAS J BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1135 116TH AVE NE STE 500, BELLEVUE, WA 98004-4627
(801) 699-8936
Mailing address
1135 116TH AVE NE STE 500, BELLEVUE, WA 98004-4627
(425) 635-6560
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
BP10047662
TX
207T00000X
Neurological Surgery Physician
DR.0058235
CO
2084E0001X
Epilepsy Physician
Primary
1578907671
WA
2084N0400X
Neurology Physician
61345139
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028905
KAISER COMMERCIAL NUMBER
CO
05
—
9000149868
—
CO
Enumeration date
04/20/2013
Last updated
10/30/2023
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