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Individual

TONY BULLON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
1834 CLAIRMONT RD STE 100, DECATUR, GA 30033
(404) 634-4443
(404) 634-4444
Mailing address
2945 UMBERLAND DR, ATLANTA, GA 30340-4904
(817) 526-4014

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
58159
TN
207QA0505X
Adult Medicine Physician
Primary
76895
GA

Other

Enumeration date
04/06/2015
Last updated
03/21/2019
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