National Provider Identifier
Kent Bullis, MD
Kent Bullis, MD is listed in the NPPES registry with a primary specialty of Adolescent Medicine (Family Medicine) Physician in Ithaca, NY and a listed phone number of (607) 255-5155.
Profile Overview
- NPI
- 1710079736
- Provider Type
- Individual
- Primary Specialty
- Adolescent Medicine (Family Medicine) Physician
- Enumeration Date
- September 28, 2006
- Last Updated
- September 26, 2013
Practice Location
- 110 Ho Plz
- Ithaca, NY 14853-3102
Phone: (607) 255-5155
Specialties
- Adolescent Medicine (Family Medicine) Physician (207QA0000X)
Full Record
- NPI
- 1710079736
- Entity Type
- Individual
- Last Name
- Bullis
- First Name
- Kent
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 110 Ho Plz
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14853-3102
- Mailing Country
- US
- Practice Street Address
- 110 Ho Plz
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14853-3102
- Practice Country
- US
- Practice Phone
- (607) 255-5155
- Enumeration Date
- September 28, 2006
- Last Updated
- September 26, 2013
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Adolescent Medicine (Family Medicine) Physician (207QA0000X)