Individual
MR. RONALD GERALD MULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
316 N BROAD ST, WINDER, GA 30680-2150
(770) 867-3400
Mailing address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA4476
GA
Other
Enumeration date
09/16/2006
Last updated
07/08/2007
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