DAVID SHIRLEY BULLOCK (NPI# 1912058272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912058272 |
| Entity Type | Individual |
| Full Name | DAVID SHIRLEY BULLOCK |
| Credential | M.D. |
| Practice Address |
140 Newcomb Ave Mount Vernon KY 40456-2728 |
| Practice Telephone | 6062565176 |
| Practice Fax Number | 6062564401 |
| Mailing Telephone | 6062565176 |
| Mailing Fax Number | 6062564401 |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2015-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 39587 | KY | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 39587 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | BB9068900 | 01 | |
| ANTHEM BC BS | 000000495658 | 01 | |
| CAQH | 11606348 | 01 | |
| TAX ID | 611064744 | 01 | |
| CHA | 1230533 | 01 | |
| RAIL ROAD MEDICARE | P00333608 | 01 | |
| KY | 64114101 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245427251 | David Willett Bullock | Physical Medicine & Rehabilitation | 3001 Carrington Ln, Lawrence, KS 66049-1732 | 2007-10-03 |
| 1538241542 | David A Bullock | Physical Therapist | 214 Ash St, Grandview, WA 98930-1319 | 2006-10-19 |
| 1053960047 | David Alexander Bullock | Social Worker | 17320 W 12 Mile Rd Ste 101, Southfield, MI 48076-2102 | 2019-09-11 |
| 1831368802 | David Christopher Bullock | Nurse Anesthetist, Certified Registered | 3181 Sw Sam Jackson Park Rd # Uhs-2, Portland, OR 97239-3011 | 2008-02-25 |
| 1255522173 | David Alban Bullock | Chiropractor | 13466 Osborne St, Arleta, CA 91331-5522 | 2007-08-06 |
| 1447322482 | David Michael Bullock | Physical Therapist | 11120 New Hampshire Ave, Suite 506, Silver Spring, MD 20904-2633 | 2006-11-14 |
| Street Address |
140 NEWCOMB AVE |
| City | MOUNT VERNON |
| State | KY |
| Zip Code | 40456-2728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649298779 | Michael Kevin Rowe | Emergency Medicine | 140 Newcomb Ave, Mount Vernon, KY 40456-2728 | 2006-07-17 |
| 1225640022 | Jessica Carpenter | Nurse Practitioner | 140 Newcomb Ave, Mount Vernon, KY 40456-2725 | 2020-08-21 |
| 1669941860 | Brent Hasty | Social Worker | 140 Newcomb Ave, Mount Vernon, KY 40456-2725 | 2018-11-16 |
| 1851878318 | Megan Taylor Pittman | Nurse Practitioner | 140 Newcomb Ave, Mount Vernon, KY 40456-2725 | 2018-07-26 |
| 1447770920 | Cumberland Foot and Ankle Centers | Orthopaedic Surgery | 140 Newcomb Ave, Mount Vernon, KY 40456-2725 | 2017-06-26 |
| 1437680964 | Mary Joenborg | Family Medicine | 140 Newcomb Ave, Mount Vernon, KY 40456-2725 | 2017-03-26 |
| 1659802635 | Angela Richelle Debord Isaacs | Family Medicine | 140 Newcomb Ave, Mount Vernon, KY 40456-2725 | 2017-03-22 |
| 1285080366 | Deana P. Gabbard | Physician Assistant | 140 Newcomb Ave, Mount Vernon, KY 40456-2725 | 2016-05-09 |
| 1326420969 | Kelsey Ladd | Psychiatry & Neurology | 140 Newcomb Ave, Mount Vernon, KY 40456-2725 | 2015-06-19 |
| 1003212630 | Brandon Cowan | Emergency Medicine | 140 Newcomb Ave, Mount Vernon, KY 40456 | 2014-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700274248 | Angela Joy Silva | Counselor | 20 Lovell Court, Mt Vernon, KY 40456 | 2015-01-07 |
| 1992128045 | Health Help Inc | Pharmacy | 116 Progress Drive, Mount Vernon, KY 40456 | 2014-01-27 |
| 1376703017 | Cumberland Valley Dist Health Dept | Public Health or Welfare | 1545 Lake Cumberland Road, Mt Vernon, KY 40456 | 2008-06-16 |
| 1386803401 | Mt Vernon Partials and Dentures | Denturist | 571 Richmond Street, Mt Vernon, KY 40456 | 2008-06-04 |
| 1285817973 | Lloyd L. Cain O.d | Eyewear Supplier (Equipment, not the service) | 205 Richmond Street, Mount Vernon, KY 40456 | 2007-12-17 |
| 1669652210 | Main Street Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 150 Main Street Pharmacy, Mt Vernon, KY 40456 | 2007-11-13 |
| 1952516197 | Suzann Fenton | Specialist | 4192 Wilderness Rd, Mt. Vernon, KY 40456 | 2007-05-11 |
| 1659595304 | Rockcastle County Adult Health Care | Clinic/Center | 1260 S. Wilderness Road, Mount Vernon, KY 40456 | 2007-04-12 |
| 1790909075 | Teresa Blair | Dietitian, Registered | 145 Newcomb Ave., Rockcastle Hospital, Mt Vernon, KY 40456 | 2007-04-11 |
| 1972622066 | Tracy Renee King | Pharmacist | 110 Newcomb Avenue, Mt. Vernon, KY 40456 | 2007-03-28 |
| Find all providers in zip 40456 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669084299 | Jean Woel Latortue | Family Medicine | 506 State Tx Hwy 37, Mount Vernon, TX 75457 | 2020-08-17 |
| 1144693250 | David B. Benson, Md, Pllc | Family Medicine | 1603 S 3rd St, Mount Vernon, WA 98273-4909 | 2015-11-11 |
| 1245617828 | Choudhry Nadeem Mumtaz | Family Medicine | 209 Crossroads Pl Ste 120, Mount Vernon, IL 62864-6545 | 2015-05-02 |
| 1801221403 | Docrx, Inc. | Family Medicine | 4200 Williamson Pl, Mount Vernon, IL 62864-6705 | 2013-09-13 |
| 1457605909 | Docrx Inc | Family Medicine | 209 Crossroads Pl Ste 100, Mount Vernon, IL 62864-6545 | 2012-11-06 |
| 1427310473 | Jonathan Titus Hardin | Family Medicine | 1330 Coschocton Road, Mount Vernon, OH 43050 | 2012-06-14 |
| 1760750467 | Lower Oconee Community Hospital, Inc. | Family Medicine | 421 W Robinson Drive, Mount Vernon, GA 30445 | 2011-12-08 |
| 1336435049 | Benjamin Mclaughlin | Family Medicine | 819 S 13th St, Mount Vernon, WA 98274-4112 | 2011-06-21 |
| 1851600845 | Janet K Christiansen | Family Medicine | 13301 Egbers Kalso Rd, Mount Vernon, WA 98273-8207 | 2010-09-25 |
| 1538483722 | Lynette Marie Emery | Family Medicine | 17879 Valley Ridge Ln, Mount Vernon, WA 98274-7743 | 2010-03-17 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 40456 |
Please comment or provide details below to improve the information on DAVID SHIRLEY BULLOCK.
| 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.