George Edward Bullock Jr., MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

ATH.J00311 Issued in LA

Practice address

2000 Centurytel Center Dr
Bossier City, LA 71112-4586

Phone

(318) 752-2847

Fax

(318) 741-9032

NPI assigned

Jul 15, 2006

Last updated

Mar 5, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236211200000",
    "number": "1831115260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8938 BRANDON DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182327",
            "telephone_number": "318-464-5254",
            "fax_number": "318-741-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CENTURYTEL CENTER DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711124586",
            "telephone_number": "318-752-2847",
            "fax_number": "318-741-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "GEORGE",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2009-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "LA",
            "license": "ATH.J00311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sondra Nicole Brownfield
• Mackisha Brumant
• Andrea Bryant
• Talysa Bryant
• Jill Giardina Bugner, DPT
• William Stewart Bundrick Jr., M.D.
• Vickey M Burnett, NP
• Chantal Butler
• Heather Ann Bynog, RN
• Jennifer Byrd, PHARM. D.

• Athletic Trainer in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Athletic Trainer in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.