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Individual

DR. DANIEL ASHLEY MULLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(770) 718-1122
(770) 535-7445
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(707) 718-1122
(770) 535-4786

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
060414
GA
208600000X
Surgery Physician
26933
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01162479
AMERIGROUP
GA
01
2448767
UNITED HEALTHCARE
GA
05
269337
SC
01
4066030
CIGNA
GA
01
429270
WELLCARE
GA
01
52162699
BCBS
GA
05
530057171A
GA
05
530057171B
GA
05
530057171C
GA
05
530057171D
GA
01
9223107
AETNA
GA
01
P00219012
RAILROAD MEDICARE
SC
01
P00633303
MEDICARE RAILROAD
GA
Enumeration date
02/06/2006
Last updated
05/22/2024
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