Healthcare Provider Details

I. General information

NPI: 1508846833
Provider Name (Legal Business Name): RITA JOYCE MULLINS-HODGIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CLINIC DR
TARBORO NC
27886-1935
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 252-823-2105
  • Fax:
Mailing address:
  • Phone: 336-564-4866
  • Fax: 336-564-4869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number9900305
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9900305
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number9900305
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: