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Individual

DR. RICKEY H BULLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1902 WEST MAIN STREET, TUPELO, MS 38801
(662) 844-4766
(662) 680-6997
Mailing address
1902 WEST MAIN STREET, TUPELO, MS 38801
(662) 844-4766
(662) 680-6997

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
80058
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
19928
MS
Enumeration date
07/28/2006
Last updated
03/10/2008
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