Individual
ANDREW BRANDON BULLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
555 E BROADWAY AVE, JACKSON, WY 83001-8640
(307) 733-3900
Mailing address
555 E BROADWAY AVE, JACKSON, WY 83001-8640
(307) 733-3900
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
054468
GA
207X00000X
Orthopaedic Surgery Physician
Primary
MD.28879
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700910155
—
AL
01
—
510-40197
BCBS - 1500 ROSS CLARK CIRCLE
AL
01
—
510-40198
BCBS - 4300 W MAIN ST; STE 14
AL
05
—
564805591B
—
GA
Enumeration date
03/16/2007
Last updated
08/12/2019
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