MEDICARE: JAMES ERIC MULLINS, JR 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
1	207V00000X	Obstetrics & Gynecology Physician	JM068606	MI
2	207V00000X	Obstetrics & Gynecology Physician	ME144040	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	160050107	OTHER	MI	MEDICARE RAILROAD

Other Identifiers

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

General Provider Information

NPI Number	:	1871597518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ERIC MULLINS, JR M.D.

Provider Business Mailing Address
First Line	:	2400 N ORANGE BLOSSOM TRL STE 300
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34744-2308
Country	:	US
Telephone Number	:	407-846-7200
Fax Number	:	407-846-3989

Provider Business Practice Location Address
First Line	:	2400 N ORANGE BLOSSOM TRL STE 300
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34744-2308
Country	:	US
Telephone Number	:	407-846-7200
Fax Number	:	407-846-3989

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	02/28/2023

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Directions to “ JAMES ERIC MULLINS, JR M.D.” Practice Location

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