Provider Demographics
NPI:1043383276
Name:BULLINGTON, DOUGLAS K (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:K
Last Name:BULLINGTON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1155 W JEFFERSON ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-2730
Mailing Address - Country:US
Mailing Address - Phone:317-736-6133
Mailing Address - Fax:317-736-6403
Practice Address - Street 1:3000 S STATE ROAD 135
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-9825
Practice Address - Country:US
Practice Address - Phone:317-535-1876
Practice Address - Fax:317-535-5049
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2021-05-11
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Provider Licenses
StateLicense IDTaxonomies
IN01029416207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN080001659OtherRAILROAD MEDICARE
INB28879Medicare UPIN
INB28879Medicare UPIN