Bullock, David Shirley

Bullock, David Shirley is an individual health care provider with primary practice located at 140 Newcomb Ave , Mount Vernon KY 40456-2728. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Bullock, David Shirley can be contacted via phone (606) 256-5176.

Contact Information

Primary practice address
140 Newcomb Ave Mount Vernon KY 40456-2728
Phone: (606) 256-5176
Fax: (606) 256-4401
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 39587 Kentucky
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 39587 Kentucky

Profile Details

NPI number 1912058272
LBN Legal business name Bullock, David Shirley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2007
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912058272 NPPES
Other 611064744 TAX ID
Other P00333608 TAX ID
Other 11606348 TAX ID
MEDICAID 64114101 TAX ID
Other 000000495658 TAX ID
Other 1230533 TAX ID

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