Provider Demographics
NPI:1760524615
Name:BULKELEY, JULIA ARDEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:ARDEN
Last Name:BULKELEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 PARK RD STE 250
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2373
Mailing Address - Country:US
Mailing Address - Phone:704-323-2424
Mailing Address - Fax:
Practice Address - Street 1:1604 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5524
Practice Address - Country:US
Practice Address - Phone:910-276-4611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC03041207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1760524615OtherINTOTAL
VA1760524615Medicaid
VA1760524615OtherHEALTHKEEPERS
VA1760524615OtherCIGNA
VA1760524615OtherGATEWAY
VA1760524615OtherUMWA
VA1760524615OtherVA PREMIER
VA3810020715OtherMEDICAID OF WEST VIRGINIA
VA1760524615OtherAETNA
VA1760524615OtherUNITED HEALTHCARE
VAP01082791OtherRAILROAD MEDICARE
VA1760524615OtherANTHEM
VA1760524615OtherSOUTHERN HEALTH/CARENET/CARELINK/COVENTRY
VA1760524615OtherOPTIMA HEALTH CARE
VA1760524615OtherVIRGINIA HEALTH NETWORK
VA1760524615OtherHEALTHKEEPERS PLUS
VA1760524615OtherHUMANA MEDICARE
VA540506332118OtherTRICARE/CHAMPUS
VA540506332118OtherTRICARE/CHAMPUS
VA1760524615Medicaid