Rose Marie Shaw Bullock (NPI# 1790749943, PAC ID# 5597933473) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1790749943 |
| PAC ID by PECOS | 5597933473 |
| Professional Enrollment ID | I20110720000246 |
| Full Name | Rose Marie Shaw Bullock |
| Organization Legal Name | NORTH LITTLE ROCK PRIMARY CARE AND DIAGNOSTIC CLINIC PLLC |
| Address |
400 W Pershing Blvd North Little Rock AR 72114-2146 |
| Phone Number | 5017717717 |
| Gender | F |
| Medical School | UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE |
| Graduation Year | 1994 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 0749462786 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 040036 | BAPTIST HEALTH MEDICAL CENTER NORTH LITTLE ROCK |
| 040007 | CHI-ST VINCENT INFIRMARY |
| 040114 | BAPTIST HEALTH MEDICAL CENTER-LITTLE ROCK |
| Address | Phone | Organization |
|---|---|---|
| 6209 W 12th St, Little Rock, AR 72204-1505 | 5016635221 | ARKANSAS PRIMARY CARE CLINICS PA |
| 400 W Pershing Blvd, North Little Rock, AR 72114-2146 | 5017717717 | NORTH LITTLE ROCK PRIMARY CARE AND DIAGNOSTIC CLINIC PLLC |
| Organization Legal Name | NORTH LITTLE ROCK PRIMARY CARE AND DIAGNOSTIC CLINIC PLLC |
| Physicians | 1 |
| Street Address |
400 W PERSHING BLVD |
| City | NORTH LITTLE ROCK |
| State | AR |
| Zip | 72114-2146 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joe L Buford | Family Medicine | 410 W Pershing Blvd, North Little Rock, AR 72114-2146 | |
| Jasmine A Brathwaite | Family Medicine | Arkansas Health Group | 505 W Pershing, Suite C, North Little Rock, AR 72114-2147 |
| Adam P Grant | Family Medicine | Arkansas Health Group | 505 W Pershing, Suite C, North Little Rock, AR 72114-2147 |
| Norman R Pledger | Family Practice | Arkansas Health Group | 505 W Pershing, Suite C, North Little Rock, AR 72114-2147 |
| Kevin Girtman | Physician Assistant | Arkansas Health Group | 505 W Pershing Blvd C, North Little Rock, AR 72114-2157 |
| Zachary Hunt | Physical Therapy | 505 W Pershing Blvd, Suite D, North Little Rock, AR 72114-2157 | |
| Kelli Keene Sanders | Family Medicine | 505 W Pershing Blvd, Suite B, North Little Rock, AR 72114-2157 | |
| Mark H Kelso | Clinical Social Worker | William R. Barling, Acsw, Inc. | 2200 Main St, North Little Rock, AR 72114-2302 |
| Elizabeth A Barling | Clinical Social Worker | William R. Barling, Acsw, Inc. | 2200 Main St, North Little Rock, AR 72114-2302 |
| William R Barling | Clinical Social Worker | William R. Barling, Acsw, Inc. | 2200 Main St, North Little Rock, AR 72114-2302 |
| Find all physicians in zip 72114 | |||
| City | NORTH LITTLE ROCK |
| Zip Code | 72114 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | NORTH LITTLE ROCK + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Rose Marie Shaw Bullock.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.