Provider Demographics
NPI:1578811840
Name:BULLARD, DAVID N (MS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:N
Last Name:BULLARD
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 NAVIGATION PT SE
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30121-8180
Mailing Address - Country:US
Mailing Address - Phone:770-324-3010
Mailing Address - Fax:
Practice Address - Street 1:20 NAVIGATION PT SE
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30121-8180
Practice Address - Country:US
Practice Address - Phone:770-324-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)