Individual
DR. KENNETH HAROLD BULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3500 COMANCHE RD NE, BLDG E6, ALBUQUERQUE, NM 87107-4546
(505) 881-8666
(505) 881-3261
Mailing address
3500 COMANCHE RD NE, BLDG E6, ALBUQUERQUE, NM 87107-4546
(505) 881-8666
(505) 881-3261
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
73-99
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04556
—
NM
01
—
347735502
MEDICARE PTAN
NM
Enumeration date
07/23/2006
Last updated
06/25/2014
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