Individual
MR. JOSEPH MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3030 N CIRCLE DR, SUITE 210, COLORADO SPRINGS, CO 80909-1177
(719) 776-4800
(719) 776-4805
Mailing address
3030 N CIRCLE DR, SUITE 210, COLORADO SPRINGS, CO 80909-1177
(719) 776-4800
(719) 776-4805
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1577
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11014110
—
WI
01
—
1851477913
CMH NPI
WI
01
—
390848401050
ANTHEM
WI
Enumeration date
12/11/2006
Last updated
02/01/2012
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