Individual
ASHLEY BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
711 MARSHALL ST, LEAVENWORTH, KS 66048-3235
(913) 684-1144
Mailing address
1814 N 142ND ST, BASEHOR, KS 66007-9660
(316) 516-4048
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0440918
KS
Other
Enumeration date
05/18/2015
Last updated
09/26/2019
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