Individual
DR. ERIC MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 CRATER LAKE AVE, MEDFORD, OR 97504-6241
(541) 732-7000
Mailing address
PO BOX 8509, MEDFORD, OR 97501-5009
(541) 772-0023
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD25020
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022459
—
OR
01
—
MD25020
OREGON STATE LICENSE
OR
Enumeration date
03/17/2006
Last updated
08/05/2010
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