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NPI Code Detail

MEDICARE: DR. THOMAS N MULLEN M.D.

MEDICARE:  DR. THOMAS N MULLEN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician39882GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174520837
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS N MULLEN M.D.
Provider Business Mailing Address
First Line : 738 DEODARA DR
Second Line :
City : ALTADENA
State : CA
Zip : 91001-2310
Country : US
Telephone Number : 626-676-3797
Fax Number :
Provider Business Practice Location Address
First Line : 126 SEQUOYAH TRL
Second Line :
City : RINGGOLD
State : GA
Zip : 30736-4360
Country : US
Telephone Number : 706-965-2179
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 08/09/2010

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Directions to “ DR. THOMAS N MULLEN M.D.” Practice Location

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