Individual
CAROLYN R BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
7630 RIVERS EDGE DR, COLUMBUS, OH 43235-1337
(614) 533-4000
(614) 540-3979
Mailing address
5450 FRANTZ RD STE 360, DUBLIN, OH 43016-4141
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34002995
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0427514
—
OH
Enumeration date
01/17/2006
Last updated
06/19/2019
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