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

Jack Bullard

Individual provider Registered Dietitian · NPI 1568330983

Jack Bullard is a Registered Dietitian OR Nutrition Professional in Chandler, Arizona. Qualified in 2025, 1 year ago. Licensed in Arizona.

Years since qualifying
1
Licensed in
AZ
In the registry since
2025

Practice location Address checks out

3100 W Ray Rd Ste 201
Chandler, AZ 85226-2472
Phone: (602) 892-8680
Fax: (480) 936-7565
Show map & directions

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

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 86375126 (AZ)

Record details

NPI number1568330983
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 27, 2025
Last updated in NPPESOctober 27, 2025
Certification dateOctober 27, 2025

Medicare enrollment

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

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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