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General NPI Number Information
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NPI Number | 1609335595
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Entity Type | Individual
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Provider Name | ZACHARY MICHAEL MULLINS DO
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Gender | Male
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 12455 E 100TH ST N STE 220
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City | OWASSO
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State | OK
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Zip | 74055-4675
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Country | US
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Telephone | 918-274-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 9146 E 26TH PL
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City | TULSA
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State | OK
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Zip | 74129-6707
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Country | US
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Telephone | 214-732-9661
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 7018
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License Number State | OK
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