| Bruce D Bullock, Md Pc | |
|
8 Commons St Rutland VT 05701-4651 | |
| (802) 770-1805 | |
| (802) 773-4876 |
| Full Name | Bruce D Bullock, Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 8 Commons St, Rutland, Vermont |
| Authorized Official Name and Position | Ann M Hughes (PRACTICE MANAGER) |
| Authorized Official Contact | 8027721989 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce D Bullock, Md Pc 8 Commons St Rutland VT 05701-4651 Ph: (802) 770-1805 | Bruce D Bullock, Md Pc 8 Commons St Rutland VT 05701-4651 Ph: (802) 770-1805 |
| NPI Number | 1497271886 |
|---|---|
| Provider Enumeration Date | 08/17/2017 |
| Last Update Date | 03/28/2023 |
| Medicare PECOS PAC ID | 8628341245 |
|---|---|
| Medicare Enrollment ID | O20170901002530 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497271886 | NPI | - | NPPES |
| OVN0388 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 042.0008555 (Vermont) | Primary |
| Provider Name | Bruce D Bullock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649250358 PECOS PAC ID: 5496732745 Enrollment ID: I20040702001278 |
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