Provider Demographics
NPI:1447225511
Name:MULLIS, JAMES W JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:MULLIS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-4785
Mailing Address - Country:US
Mailing Address - Phone:256-237-2610
Mailing Address - Fax:256-236-5275
Practice Address - Street 1:721 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-4785
Practice Address - Country:US
Practice Address - Phone:256-237-2610
Practice Address - Fax:256-236-5275
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6248207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL86000OtherBLUE CROSS BLUE SHIELD
AL86000OtherBLUE CROSS BLUE SHIELD
ALC74922Medicare UPIN