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NPI Code Detail

MEDICARE: JOHN MULLINS MD

MEDICARE: JOHN MULLINS MD
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
1207P00000XEmergency Medicine PhysicianM5653ID
2207Q00000XFamily Medicine PhysicianM-5653ID

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 : 1558307280
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN MULLINS MD
Provider Business Mailing Address
First Line : PO BOX 191050
Second Line :
City : BOISE
State : ID
Zip : 83719-1050
Country : US
Telephone Number : 208-955-6522
Fax Number : 208-955-6503
Provider Business Practice Location Address
First Line : 1115 12TH AVE RD
Second Line :
City : NAMPA
State : ID
Zip : 83686-5738
Country : US
Telephone Number : 208-498-1080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2006
Last Update Date : 08/05/2013

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Directions to “ JOHN MULLINS MD” Practice Location

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