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General NPI Number Information
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NPI Number | 1841504875
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Entity Type | Organization
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Legal Business Name | YVONNE BULLARD MD PA
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Dates
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Enumeration Date | 08/02/2010
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Last Update Date | 08/06/2010
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Provider Practice Location Address
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Address Line | 801 E 6TH ST STE 606
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City | PANAMA CITY
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State | FL
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Zip | 32401-3645
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Country | US
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Telephone | 850-785-2229
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Fax | 850-785-1806
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Provider Business Mailing Address
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Address Line | 801 E 6TH ST STE 606
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City | PANAMA CITY
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State | FL
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Zip | 32401-3645
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Country | US
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Telephone | 850-785-2229
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Fax | 850-785-1806
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Authorized Official
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Title or Position | PHYSICIAN
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Name | YVONNE BULLARD
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Credential | MD
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Telephone | 850-785-2229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | ME0053167
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License Number State | FL
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