Provider Demographics
NPI:1841214434
Name:BULLARD, LAWRENCE E JR (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:E
Last Name:BULLARD
Suffix:JR
Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:PO BOX 1076
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-1076
Mailing Address - Country:US
Mailing Address - Phone:770-532-7179
Mailing Address - Fax:770-534-1312
Practice Address - Street 1:743 SPRING ST NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3715
Practice Address - Country:US
Practice Address - Phone:770-532-7179
Practice Address - Fax:770-534-1312
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2012-03-28
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Provider Licenses
StateLicense IDTaxonomies
NY240495207L00000X
GA061402207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology