Healthcare Provider Details

I. General information

NPI: 1659370807
Provider Name (Legal Business Name): RICHARD T MULL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 NEW HOPE RD QUAIL VALLEY MEDICAL CENTER NO 7
PRINCETON WV
24740-2155
US

IV. Provider business mailing address

200 NEW HOPE RD PO BOX 1559
PRINCETON WV
24740-2155
US

V. Phone/Fax

Practice location:
  • Phone: 304-487-1076
  • Fax: 304-425-9499
Mailing address:
  • Phone: 304-487-1076
  • Fax: 304-425-9499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number15484
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number15484
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number15484
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number15484
License Number StateWV
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number15484
License Number StateWV
# 6
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number15484
License Number StateWV
# 7
Primary TaxonomyN
Taxonomy Code2085R0205X
TaxonomyRadiological Physics Physician
License Number15484
License Number StateWV
# 8
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number15484
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: