KENNETH PENN BULLARD


Address: 1225 Charter Place, Charlotte, NC 28211-5503
Phone: 7043642358

KENNETH PENN BULLARD (NPI# 1851452296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1851452296
Entity Type Individual
Full Name KENNETH PENN BULLARD
Credential MD
Practice Address 1225 Charter Place
Charlotte
NC 28211-5503
Practice Telephone 7043642358
Mailing Telephone 7043642358
Enumeration Date 2006-12-12
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208200000X Plastic Surgery 15028 NC Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
SC 360677 05
NC BLUE CROSS BLUE SHIELD 19723 01
NC 8919723 05

Office Location

Street Address 1225 CHARTER PLACE
City CHARLOTTE
State NC
Zip Code 28211-5503

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NPI Name Taxonomy Address Enumeration
1184277832 I and J Wheelchair Transportation Non-emergency Medical Transport (VAN) 1512 Delane Avenue, Charlotte, NC 28211 2019-07-22
1922563923 The Charlotte-mecklenburg Hospital Authority Psychiatry & Neurology 447 Billingsley Rd, Cottage A, Charlotte, NC 28211 2019-02-04
1649798273 Ally Home Care Charlotte LLC In Home Supportive Care 3711 Latrobe Drive Suite 520, Charlotte, NC 28211 2017-09-04
1154866770 Vaibhav Bajaj Dentist 2809 Coltsgate Rd Ste 200, Charlotte, NC 28211 2017-01-05
1508254939 Lindsay Marie Smits Speech-Language Pathologist 427 N. Wendover Rd., Charlotte, NC 28211 2015-01-08
1457755480 Kristen Hammer Physical Therapy Assistant 4120 Providence Rd Apt D, Charlotte, NC 28211 2014-10-20
1669805610 Carla Elizabeth Scott Physical Therapist 3500 Ellington Street, Dr. Carlton Watkins Center, Charlotte, NC 28211 2013-08-14
1760726368 Jill Hensdale Shipp Social Worker 307 Hunter Lane, Charlotte, NC 28211 2012-11-20
1346592722 Danielle Marie Benoit Occupational Therapist 3541 Randolph Road Suite 100 W, Charlotte, NC 28211 2012-10-09
1487910832 John Joseph Marcel Jr. Orthopaedic Surgery 449 North Wendover Rd Ste A, Charlotte, NC 28211 2012-04-10
Find all providers in zip 28211

Taxonomy Information

Taxonomy Code 208200000X
Grouping Allopathic & Osteopathic Physicians
Classification Plastic Surgery

Taxonomy Definition

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1346790821 Carolinas Skin Center Pa Plastic Surgery 3315 Springbank Lane, Suite 202, Charlotte, NC 28226 2016-10-10
1639479595 Edward Joseph Bednar Plastic Surgery 439 N Wendover Rd, Charlotte, NC 28211-1064 2010-10-26
1053452615 Jarrod Ryan Daniel Plastic Surgery 2215 Randolph Road, Charlotte, NC 28207 2007-02-08
1255479895 Adam Christian Augenstein Plastic Surgery 11835 Southmore Dr, Ste 202, Charlotte, NC 28277-4466 2007-02-04
1144328493 Michael H Carstens Plastic Surgery 1719 South Blvd # B, Charlotte, NC 28203-4727 2006-09-20
1902888977 Hope Sherie Plastic Surgery 325 Arlington Ave # B, Charlotte, NC 28203-4271 2005-11-16
1124029707 Gregory Allen Mantooth Plastic Surgery 5815 Blakeney Park Dr Ste 100, Charlotte, NC 28277-5732 2005-08-09
1912370602 Aesthetic Surgery of Charlotte Pllc Plastic Surgery 11835 Southmore Dr, Suite 202, Charlotte, NC 28277-4466 2015-11-04
1225437643 Queen City Plastic Surgery Pllc Plastic Surgery 3025 Springbank Ln, Suite 240, Charlotte, NC 28226-3362 2014-08-21
1316246788 Jason Korn Plastic Surgery 1025 Morehead Medical Dr, Ste 200, Charlotte, NC 28204-2963 2011-03-24
Find all providers in CHARLOTTE

Competitor

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City CHARLOTTE
Zip Code 28211

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Dataset Information

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.

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