Bullock, John David
Bullock, John David is an individual health care provider with primary practice located at 1238 Highway 42 , Sumrall MS 39482. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bullock, John David can be contacted via phone (601) 758-3100.Contact Information
Primary practice address
1238 Highway 42
Sumrall MS 39482
Phone: (601) 758-3100
Fax: (601) 758-3008
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 12095 | Mississippi |
Profile Details
| NPI number | 1942217757 |
|---|---|
| LBN Legal business name | Bullock, John David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2006 |
| Last updated | Jul 14th, 2020 - about 6 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 | 1942217757 | NPPES |
| Mississippi | MEDICAID | 00121120 | |
| Mississippi | Other | 1559122 |
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