Provider Demographics
NPI:1417466640
Name:HITT, KARLA MULLIS (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:MULLIS
Last Name:HITT
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MISS
Other - First Name:MANDYE
Other - Middle Name:KARLA
Other - Last Name:MULLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:147 SHAMUS WAY
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:GA
Mailing Address - Zip Code:30549-7645
Mailing Address - Country:US
Mailing Address - Phone:770-900-7454
Mailing Address - Fax:
Practice Address - Street 1:50 SUMNER WAY
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:GA
Practice Address - Zip Code:30549-7074
Practice Address - Country:US
Practice Address - Phone:706-389-1089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-20
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT005850208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation