DR. MALTON JOSEPH BULLOCK JR. (NPI# 1356547434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356547434 |
| Entity Type | Individual |
| Full Name | DR. MALTON JOSEPH BULLOCK JR. |
| Credential | M.D. |
| Practice Address |
4423 Pine Park Dr Baton Rouge LA 70809-6922 |
| Practice Telephone | 2259244488 |
| Practice Fax Number | 2259241531 |
| Mailing Telephone | 2259244488 |
| Mailing Fax Number | 2259241531 |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 04483R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1195421 | 05 |
| Street Address |
4423 PINE PARK DR |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70809-6922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619582640 | Lisha Kerr Jacobsen | Counselor | 7936 Wrenwood Drive, Bldg # A, Baton Rouge, LA 70809 | 2020-09-15 |
| 1790301596 | Louisiana Regenerative Medicine Center | Clinic/Center | 9456 Jefferson Hwy St A, Baton Rouge, LA 70809 | 2020-06-18 |
| 1093337305 | Sew Luxe Customs, LLC | Prosthetic/Orthotic Supplier | 8674 Quarters Lake Road, Building 11 Suit 1, Baton Rouge, LA 70809 | 2020-05-08 |
| 1366903908 | Tamika Wyna Piper | Counselor | 11445 Reiger Road, Baton Rouge, LA 70809 | 2019-03-27 |
| 1548734213 | Urg-hab Surgical Specialists | Pain Medicine | 8558 Jefferson Hwy, Baton Rouge, LA 70809 | 2019-01-16 |
| 1205306610 | Monique West | Case Manager/Care Coordinator | 9441 Common Street, Suite B, Baton Rouge, LA 70809 | 2018-11-28 |
| 1679061618 | Sara Elizabeth Nicole Altaean | Massage Therapist | Ability Massage & Day Spa, 7656 Jefferson Hwy Suite 1a, Baton Rouge, LA 70809 | 2018-04-25 |
| 1871098921 | Gary Bernard Jr. | Massage Therapist | 7656 Jefferson Hwy Suite 1a, Baton Rouge, LA 70809 | 2018-03-29 |
| 1619476355 | De'andria Banks | Behavior Technician | 9150 Bareford Drive, Baton Rouge, LA 70809 | 2018-02-08 |
| 1427561679 | Angiogenesis Medical LLC | Durable Medical Equipment & Medical Supplies | 8032 Summa Ave Ste D, Baton Rouge, LA 70809 | 2017-11-09 |
| Find all providers in zip 70809 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316381262 | Karli Mizell Boggs | Obstetrics & Gynecology | 500 Rue De La Vie St Ste 404, Baton Rouge, LA 70817-5128 | 2013-04-22 |
| 1689929051 | Jolie Caroline Bourgeois | Obstetrics & Gynecology | 500 Rue De La Vie St Ste 210, Baton Rouge, LA 70817-5128 | 2012-07-20 |
| 1245509397 | Therese Landry Demouy | Obstetrics & Gynecology | 13717 Earls Ct, Baton Rouge, LA 70810-3587 | 2011-12-19 |
| 1417225335 | Richard Haughton Tannehill | Obstetrics & Gynecology | 2728 Windrush Way, Baton Rouge, LA 70809-1126 | 2011-12-06 |
| 1225356686 | Merritt F. Melker IIi | Obstetrics & Gynecology | 18322 N Mission Hills Ave, Baton Rouge, LA 70810-7972 | 2010-05-11 |
| 1346481314 | Christy Hartmann Cycotte | Obstetrics & Gynecology | 500 Rue De La Vie St Ste 407, Baton Rouge, LA 70817-5128 | 2009-03-20 |
| 1194900761 | Nicole Hebert Chauvin | Obstetrics & Gynecology | 500 Rue De La Vie, Ste 305, Baton Rouge, LA 70817-5126 | 2008-01-02 |
| 1982725701 | Dorsay D Bryant | Obstetrics & Gynecology | 1820 N Acadian Thruway W, Baton Rouge, LA 70802-1857 | 2007-04-02 |
| 1508981051 | Joseph Wesley Diggs | Obstetrics & Gynecology | 412 N Acadian Thruway, Baton Rouge, LA 76806 | 2007-03-20 |
| 1679615702 | Marilyn Marie Reynaud | Obstetrics & Gynecology | 7173a Florida Boulevard, Baton Rouge, LA 70806-4549 | 2007-02-13 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70809 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.