Search › Georgia › 207R00000X
Colette Bullock, DO
NPI 1164612370 · on the registry since 2007 · sole proprietor
Practice
- Address
- 5422 Cumming Hwy Ste 104
Sugar Hill, GA 30518 - Phone
- (678) 466-9193
- Fax
- (877) 991-5350
- Organisation at this address
- Legacy Medical, Llc
Sunflower Pediatrics LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 207R00000X
207R00000X
- Also registered as
- 207R00000X
207R00000X - Licence states on file
- PA, NJ, GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-10-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia