Provider Demographics
NPI:1437373271
Name:MCMULLAN JR, JOHN BARTON (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BARTON
Last Name:MCMULLAN JR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 SW MARKET STREET
Mailing Address - Street 2:MS E12A
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97207-1271
Mailing Address - Country:US
Mailing Address - Phone:503-225-5351
Mailing Address - Fax:503-226-8795
Practice Address - Street 1:100 SW MARKET ST
Practice Address - Street 2:MS E12A
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97207-1271
Practice Address - Country:US
Practice Address - Phone:503-225-5351
Practice Address - Fax:503-226-8795
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR8140207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine