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General NPI Number Information
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NPI Number | 1386189223
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Entity Type | Individual
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Provider Name | JAMES MULLEN
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Gender | Male
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Dates
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Enumeration Date | 01/02/2017
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 164 MOUNT PLEASANT RD STE 202
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City | NEWTOWN
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State | CT
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Zip | 06470-1477
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Country | US
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Telephone | 203-270-1016
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Fax |
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Provider Business Mailing Address
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Address Line | 404 MOSER LN
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City | KNOXVILLE
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State | TN
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Zip | 37934-4043
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Country | US
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Telephone | 865-661-6272
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 3102
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4898
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License Number State | CT
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