Healthcare Provider Details

I. General information

NPI: 1609002237
Provider Name (Legal Business Name): SARA M. MULLINS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2009
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 18TH ST S STE 601
BIRMINGHAM AL
35233-1856
US

IV. Provider business mailing address

1830 14TH AVE S STE 3
BIRMINGHAM AL
35205-4909
US

V. Phone/Fax

Practice location:
  • Phone: 205-325-8372
  • Fax: 205-325-8270
Mailing address:
  • Phone: 205-933-2250
  • Fax: 205-933-2221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD.30391
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: