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NPI Profile for GINA M BULLOCK in PORTLAND, OR.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgery, Foot & Ankle |
213ES0103X | 48 | Podiatry |
| NPI Number | 1255440020 |
|
| Status | Active | |
| Credentials | DPM (Doctor of Podiatric Medicine) | |
| Entity | Individual | |
| Enumeration date | 08/29/2006 | |
| Last updated | 03/07/2023 - About 3 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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GINA M BULLOCK
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GINA M BULLOCK, DPM