Lance E Bullock, Md, A Professional Medical Corporation

NPI 1265465397 - Psychiatry & Neurology - 2084P0800X

NPI Details
NPI 1265465397
Enumeration Date 07/09/2006
Last Updated 05/21/2009
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name SHARON F SHARON
Position OFFICE ADMINISTRATOR
Phone (225) 647-7524
Fax
Practice Location
3136 S SAINT LANDRY AVE
GONZALES LA, 70737-5801, US
Phone (225) 647-7524
Fax
Business Location
37459 ULTIMA PLAZA BLVD, SUITE B, PMB 227
PRAIRIEVILLE LA, 70769-3856, US
Phone (225) 673-8258
Fax (225) 673-2340
Toxanomy
Taxonomy Code 2084P0800X
License State Louisiana
License Number 09761R
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According to our database, Lance E Bullock, Md, A Professional Medical Corporation NPI is 1265465397, taxonomy code is 2084P0800X and license number is 09761R, license state is located at Louisiana. Lance E Bullock, Md, A Professional Medical Corporation physically located at 3136 S Saint Landry Ave, Gonzales LA, 70737-5801. NPI Number 1033115704 has the healthcare provider type.

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1265465397 NPI number is provided on an as is basis without warranty of any kind. 1265465397 is maintained by the National Plan & Provider Enumeration System. The contents of Lance E Bullock, Md, A Professional Medical Corporation are for informational purposes only.