Individual
DR. RYAN DAVID MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10234 MARION PARK DR, KANSAS CITY, MO 64137-1405
(816) 201-3593
Mailing address
10234 MARION PARK DR, KANSAS CITY, MO 64137-1405
(816) 201-3593
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-36926
KS
207Q00000X
Family Medicine Physician
2014013905
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123633
SUPERIOR HEALTH/CHIPS
TX
05
—
144234506
—
TX
01
—
7164442
AETNA
TX
01
—
752616977118
TRICARE
TX
01
—
8P9043
BCBS
TX
01
—
TAX ID PLUS 041
TRICARE TRINITY CLINIC
TX
01
—
TAX ID PLUS 088
TRICARE TRINITY CLINIC
TX
Enumeration date
02/16/2006
Last updated
06/13/2016
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