| David Shirley Bullock, MD | |
|
140 Newcomb Ave, Mount Vernon, KY 40456-2728 | |
| (606) 256-5176 | |
| (606) 256-4401 |
| Full Name | David Shirley Bullock |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 22 Years |
| Location | 140 Newcomb Ave, Mount Vernon, Kentucky |
| 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 |
|---|---|---|---|
| 1912058272 | NPI | - | NPPES |
| 611064744 | Other | TAX ID | |
| P00333608 | Other | RAIL ROAD MEDICARE | |
| 11606348 | Other | CAQH | |
| 64114101 | Medicaid | KY | |
| 000000495658 | Other | ANTHEM BC BS | |
| 1230533 | Other | CHA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 39587 (Kentucky) | Primary |
| 207P00000X | Emergency Medicine | 39587 (Kentucky) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lifeline Rockcastle Home Health | Mount vernon, KY | Home health agency |
| Cumberland Valley District Health Dept Hha | Manchester, KY | Home health agency |
| Rockcastle County Hospital, Inc. | Mount vernon, KY | Hospital |
| Lake Cumberland Regional Hospital | Somerset, KY | Hospital |
| Baptist Health Richmond | Richmond, KY | Hospital |
| Saint Joseph Berea | Berea, KY | Hospital |
| University Of Kentucky Hospital | Lexington, KY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Rockcastle Emergency Group, Llc | 3971923814 | 11 |
| Rockcastle County Hospital, Inc. | 6103727433 | 33 |
| Entity Name | Rockcastle County Hospital, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104890714 PECOS PAC ID: 6103727433 Enrollment ID: O20040119000523 |
| Entity Name | Southeastern Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050302000285 |
| Entity Name | Rockcastle Emergency Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225640154 PECOS PAC ID: 3971923814 Enrollment ID: O20201015000813 |
| Mailing Address | Practice Location Address |
|---|---|
| David Shirley Bullock, MD 140 Newcomb Ave, Mount Vernon, KY 40456-2728 Ph: (606) 256-5176 | David Shirley Bullock, MD 140 Newcomb Ave, Mount Vernon, KY 40456-2728 Ph: (606) 256-5176 |
Jon Anthony Arvin, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 116 Progress Dr, Mount Vernon, KY 40456 Phone: 606-256-2143 Fax: 606-256-9762 | |
Thomas W Fowles, MD Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 942 W Main St Unit B, Mount Vernon, KY 40456 Phone: 606-392-2207 Fax: 606-392-2139 | |
Mary Joenborg, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 140 Newcomb Ave, Mount Vernon, KY 40456 Phone: 606-256-2195 | |
George W Griffith, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 140 Newcomb Ave, Mount Vernon, KY 40456 Phone: 606-256-2961 Fax: 606-256-3562 | |
Dr. Michael Kevin Rowe, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 140 Newcomb Ave, Mount Vernon, KY 40456 Phone: 606-256-4148 Fax: 606-256-5191 | |
Angela Richelle Debord Isaacs, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 140 Newcomb Ave, Mount Vernon, KY 40456 Phone: 606-256-5176 Fax: 606-256-5191 | |
Rebecca Dawn Hammond, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 140 Newcomb Ave, Mount Vernon, KY 40456 Phone: 606-256-4148 Fax: 606-256-5191 |