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NPI Code Detail

MEDICARE: DR. WILLIAM GREGORY MULLINAX M.D.

MEDICARE:  DR. WILLIAM GREGORY MULLINAX  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
1207QH0002XHospice and Palliative Medicine (Family Medicine) Physician31104MS
2207QH0002XHospice and Palliative Medicine (Family Medicine) Physician36834TN

General Provider Information

NPI Number : 1972551364
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM GREGORY MULLINAX M.D.
Provider Business Mailing Address
First Line : 965 RIDGE LAKE BLVD STE 315
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-9401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1500 W POPLAR AVE
Second Line :
City : COLLIERVILLE
State : TN
Zip : 38017-0601
Country : US
Telephone Number : 901-226-2800
Fax Number : 901-226-2802
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 02/09/2023

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