Individual
MEGAN MCDANIEL MULLICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FAAA, CC-A, MS
Contact information
Practice address
1605 S 28TH AVE, HATTIESBURG, MS 39402-3110
(601) 579-3310
(601) 264-0231
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5463
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A0622
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00791976
RAILROAD MEDICARE
MS
Enumeration date
03/31/2008
Last updated
02/05/2015
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