Bultman, Richard J

Bultman, Richard J is an individual health care provider with primary practice located at 1594 Kingsley Ave , Orange Park FL 32073-4546. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bultman, Richard J can be contacted via phone (904) 264-8621.

Contact Information

Primary practice address
1594 Kingsley Ave Orange Park FL 32073-4546
Phone: (904) 264-8621
Fax: (904) 215-9418
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME017622 Florida

Profile Details

NPI number 1316946189
LBN Legal business name Bultman, Richard J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Feb 1st, 2022 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316946189 NPPES
Florida MEDICAID 000458300
Florida Other 02009
Florida Other ME017622

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