# KEVIN MICHAEL MCMULLEN MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124005533
- **Authorized official:** KEVIN MICHAEL MCMULLEN MD (PRESIDENT/OWNER)
- **Authorized official phone:** (405) 749-8346

## Contact information

- **Practice address:** 11011 HEFNER POINTE DR, SUITE A, OKLAHOMA CITY, OK 73120-5005
- **Practice address phone:** (405) 749-8346
- **Practice address fax:** (405) 749-8349
- **Mailing address:** PO BOX 26525, SECTION 47, OKLAHOMA CITY, OK 73126-0525
- **Mailing address phone:** (405) 749-8346
- **Mailing address fax:** (405) 749-8349

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 17646 | OK | Yes |

## Other

- **Enumeration date:** 12/28/2005
- **Last updated:** 09/19/2014