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NPI Code Detail

MEDICARE: DR. BRUCE D BULLOCK MD

MEDICARE: DR. BRUCE D BULLOCK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician0420008555VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649250358
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRUCE D BULLOCK MD
Provider Business Mailing Address
First Line : 8 COMMONS ST
Second Line :
City : RUTLAND
State : VT
Zip : 05701-4651
Country : US
Telephone Number : 802-770-1805
Fax Number : 802-773-4876
Provider Business Practice Location Address
First Line : 8 COMMONS ST
Second Line :
City : RUTLAND
State : VT
Zip : 05701-4651
Country : US
Telephone Number : 802-770-1805
Fax Number : 802-773-4876
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2006
Last Update Date : 03/28/2023

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Directions to “ DR. BRUCE D BULLOCK MD” Practice Location

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