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NPI Code Detail

MEDICARE: DR. TIMOTHY JASON BULLOCK MD, MPH

MEDICARE: DR. TIMOTHY JASON BULLOCK MD, MPH
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
12084P0800XPsychiatry PhysicianMD472094PA

General Provider Information

NPI Number : 1710367248
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY JASON BULLOCK MD, MPH
Provider Business Mailing Address
First Line : 810 CLAIRTON BLVD STE 500600
Second Line :
City : PITTSBURGH
State : PA
Zip : 15236-5505
Country : US
Telephone Number : 412-650-1100
Fax Number : 412-650-1101
Provider Business Practice Location Address
First Line : 810 CLAIRTON BLVD STE 500600
Second Line :
City : PITTSBURGH
State : PA
Zip : 15236-5505
Country : US
Telephone Number : 412-650-1100
Fax Number : 412-650-1101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2015
Last Update Date : 03/06/2026

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