Mr Travis L Bullock, MD | |
12855 N 40 Dr Ste 350, Saint Louis, MO 63141-8669 | |
(314) 567-6071 | |
(314) 567-3321 |
Full Name | Mr Travis L Bullock |
---|---|
Gender | Male |
Speciality | Urology |
Experience | 22 Years |
Location | 12855 N 40 Dr Ste 350, Saint Louis, Missouri |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699810507 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | 2007030776 (Missouri) | Primary |
208800000X | Urology | 036113441 (Illinois) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Anderson Hospital | Maryville, IL | Hospital |
Missouri Baptist Medical Center | Town and country, MO | Hospital |
Hshs St Elizabeth's Hospital | O fallon, IL | Hospital |
Alton Memorial Hospital | Alton, IL | Hospital |
St Joseph's Hospital | Highland, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Urology Of St. Louis, Inc | 6204723786 | 59 |
Urology Of St. Louis, Inc | 6204723786 | 59 |
Entity Name | Urology Of St. Louis, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1528017191 PECOS PAC ID: 6204723786 Enrollment ID: O20050502001141 |
Entity Name | Osf Multi-specialty Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
Entity Name | Ahs Il Medical Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659098101 PECOS PAC ID: 5496111676 Enrollment ID: O20230512001300 |
Mailing Address | Practice Location Address |
---|---|
Mr Travis L Bullock, MD 12855 N. Forty Dr., Ste 375, St. Louis, MO 63141 Ph: (314) 567-6071 | Mr Travis L Bullock, MD 12855 N 40 Dr Ste 350, Saint Louis, MO 63141-8669 Ph: (314) 567-6071 |
Dr. Charles Phillips Jones, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 4921 Parkview Pl, Div Surg Urology, Ste 11c, Saint Louis, MO 63110 Phone: 314-362-8200 Fax: 314-454-5244 | |
Dr. Carl G Klutke, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 1040 N Mason Rd, Ste 122, Saint Louis, MO 63141 Phone: 314-996-8060 Fax: 314-747-4871 | |
Dr. Nitai C Saha, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 533 Couch Ave, Suite 174, Saint Louis, MO 63122 Phone: 314-822-1413 Fax: 314-822-1859 | |
Michael James Glamore, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110 Phone: 314-362-5000 | |
Dr. James Kelly, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 3915 Watson Rd Ste 203, Saint Louis, MO 63109 Phone: 314-771-5822 Fax: 314-771-5827 | |
Maung Htein Thu, M.D Urology Medicare: Accepting Medicare Assignments Practice Location: 12700 Southfork Rd Ste 260, Saint Louis, MO 63128 Phone: 314-543-5270 | |
Dr. Zeynep Gul, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 4921 Parkview Pl, Div Surg Urology, Ste 11c, Saint Louis, MO 63110 Phone: 314-362-8200 Fax: 314-454-5244 |