Provider Demographics
NPI:1740225705
Name:MULLINS, DANNY A (MD)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:A
Last Name:MULLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 MEDICAL PARK BLVD
Mailing Address - Street 2:STE 300E
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620
Mailing Address - Country:US
Mailing Address - Phone:423-844-6450
Mailing Address - Fax:423-844-6499
Practice Address - Street 1:1 MEDICAL PARK BLVD
Practice Address - Street 2:STE 300E
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620
Practice Address - Country:US
Practice Address - Phone:423-844-6450
Practice Address - Fax:423-844-6499
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN42551207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1740225705Medicaid
TN3000481Medicaid
TNH04430Medicare UPIN
TNP00432933Medicare PIN
TN3000481Medicare PIN