Provider Demographics
NPI:1295854271
Name:JOHN R BULLMASTER MD INC
Entity Type:Organization
Organization Name:JOHN R BULLMASTER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BULLMASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-228-0789
Mailing Address - Street 1:160 WYOMING ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2740
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:160 WYOMING ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2740
Practice Address - Country:US
Practice Address - Phone:937-228-0789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35046302208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty