Provider Demographics
NPI:1881628998
Name:MULLINS, CHARLES ANDREW (DO)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ANDREW
Last Name:MULLINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2557 HIGHWAY 41 S
Mailing Address - Street 2:
Mailing Address - City:GREENBRIER
Mailing Address - State:TN
Mailing Address - Zip Code:37073-5516
Mailing Address - Country:US
Mailing Address - Phone:615-643-4534
Mailing Address - Fax:615-643-4537
Practice Address - Street 1:2557 HIGHWAY 41 S
Practice Address - Street 2:
Practice Address - City:GREENBRIER
Practice Address - State:TN
Practice Address - Zip Code:37073-5516
Practice Address - Country:US
Practice Address - Phone:615-643-4534
Practice Address - Fax:615-643-4537
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO-717207Q00000X
TN3608207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL7820309OtherAETNA
AL51527790OtherBCBS OF AL
AL051555830Medicaid
AL51527790OtherBCBS OF AL
AL7820309OtherAETNA