Provider Demographics
NPI:1689445603
Name:MULLINS, DAVID PRINTUS (PA-C)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PRINTUS
Last Name:MULLINS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 850
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37857-0850
Mailing Address - Country:US
Mailing Address - Phone:423-921-6975
Mailing Address - Fax:423-921-6920
Practice Address - Street 1:1861 MAIN ST
Practice Address - Street 2:
Practice Address - City:SNEEDVILLE
Practice Address - State:TN
Practice Address - Zip Code:37869-3645
Practice Address - Country:US
Practice Address - Phone:423-733-2131
Practice Address - Fax:432-733-1055
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN5742363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant