Individual
JERALD MULLERSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
BUILDING 119, MOUNTAIN HOME, TN 37684-0699
(423) 439-7029
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 433-6039
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
Primary
MD24976
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3401897
LAB MEDICARE PIN
TN
Enumeration date
12/31/2007
Last updated
10/25/2012
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