Provider Demographics
NPI:1508038944
Name:MULLINS, JEFFREY K (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:K
Last Name:MULLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:725 GLENWOOD DRIVE
Mailing Address - Street 2:SUITE E790
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404
Mailing Address - Country:US
Mailing Address - Phone:423-495-3068
Mailing Address - Fax:423-495-3022
Practice Address - Street 1:725 GLENWOOD DRIVE
Practice Address - Street 2:SUITE E790
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404
Practice Address - Country:US
Practice Address - Phone:423-495-3068
Practice Address - Fax:423-495-3022
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2015-06-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WVF448483208800000X
TN52616208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology