Individual
DR. EARL NICHOLAS MULLIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
380 HOSPITAL DR STE 320, MACON, GA 31217-8007
(478) 750-8606
Mailing address
113 LAGRANGE PL, MACON, GA 31210-1473
(478) 746-2770
(478) 746-0000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
31999
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004302C
—
GA
Enumeration date
07/11/2006
Last updated
10/25/2023
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