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General NPI Number Information
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NPI Number | 1386798502
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Entity Type | Individual
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Provider Name | SUZANNE ELIZABETH MULLIS PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 341 GREENO RD N
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City | FAIRHOPE
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State | AL
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Zip | 36532-2979
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Country | US
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Telephone | 251-928-2401
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Fax | 251-928-5099
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Provider Business Mailing Address
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Address Line | 1720 SPRING HILL AVE STE 3
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City | MOBILE
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State | AL
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Zip | 36604-1410
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.454
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License Number State | AL
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