Provider Demographics
NPI:1245288653
Name:BULLARD, DARRYLE P (MD)
Entity type:Individual
Prefix:DR
First Name:DARRYLE
Middle Name:P
Last Name:BULLARD
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2895
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35056-2895
Mailing Address - Country:US
Mailing Address - Phone:256-735-5175
Mailing Address - Fax:256-417-4269
Practice Address - Street 1:1890 AL HIGHWAY 157
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-3601
Practice Address - Country:US
Practice Address - Phone:256-903-0300
Practice Address - Fax:256-801-7893
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26800207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL277627Medicaid
AL260625Medicaid