DR. Kelly Leigh Bullock, D.O.

NPI #1407941057 in Randolph, Nebraska

Provider Information

NPI Number: 1407941057
Entity Type: Individual
Name: DR. Kelly Leigh Bullock, D.O.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Family Medicine
Credential: D.O.
Enumeration Date: Oct 3, 2006
Last Updated: Feb 15, 2022

Practice Location

Address: 106 E WAYNE ST
City: Randolph
State: Nebraska
ZIP Code: 68771-5300
Phone: (402) 337-0200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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Organizations

Provider Name	Specialty	City
Osmond General Hospital INC Part of Osmond General Hospital INC	Family Medicine	Randolph	AI Deep Dive

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