Bullock, Eric D
Bullock, Eric D is an individual health care provider with primary practice located at 2400 N Rockton Ave , Rockford IL 61103-3655. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hospitalist, which is considered as his primary health care specialty. Bullock, Eric D can be contacted via phone (815) 971-5000.Contact Information
Primary practice address
2400 N Rockton Ave
Rockford IL 61103-3655
Phone: (815) 971-5000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 036-104034 | Illinois |
Profile Details
| NPI number | 1417067695 |
|---|---|
| LBN Legal business name | Bullock, Eric D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Dec 22nd, 2009 - about 15 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417067695 | NPPES |
| Illinois | MEDICAID | 036104034 |
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