Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Olivia Michelle Bullock, DO

Individual provider Family Medicine Physician · NPI 1114542859

Olivia Michelle Bullock, DO is a Family Practice in Saint Johns, Florida. Graduated from Lake Erie College of Osteopathic Medicine, Erie in 2020, 6 years ago. Practices with Baptist Primary Care Inc, a 457-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
6
Trained at
Lake Erie College of Osteopathic Medicine, Erie
Licensed in
FL
In the registry since
2020
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

1310 County Road 210 W
Saint Johns, FL 32259
Phone: (904) 824-4407
Fax: (904) 390-7459
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 14540 Old Saint Augustine Rd Ste 2317, Jacksonville, FL 32258-7418 — (904) 824-4407

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence OS18963 (FL)

Record details

NPI number1114542859
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorYes
NPI enumeratedJune 9, 2020
Last updated in NPPESAugust 15, 2023
Certification dateAugust 11, 2023
Mailing addressPo Box 746638, Atlanta, GA 30374-6638

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated 2020 (6 years in practice)
Group practice Baptist Primary Care Inc — 457 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Saint Johns