Individual
DAVID SHIRLEY BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
140 NEWCOMB AVE, MOUNT VERNON, KY 40456-2728
(606) 256-5176
(606) 256-4401
Mailing address
140 NEWCOMB AVE, MOUNT VERNON, KY 40456-2728
(606) 256-5176
(606) 256-4401
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
39587
KY
207Q00000X
Family Medicine Physician
Primary
39587
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000495658
ANTHEM BC BS
—
01
—
11606348
CAQH
—
01
—
1230533
CHA
—
01
—
611064744
TAX ID
—
05
—
64114101
—
KY
01
—
P00333608
RAIL ROAD MEDICARE
—
Enumeration date
01/15/2007
Last updated
03/07/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us