Individual
DR. SCOTT DAVID MULLANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1925 FLORENCE AVE, KINGMAN, AZ 86401-4617
(928) 753-2106
(928) 753-4283
Mailing address
1925 FLORENCE AVE, KINGMAN, AZ 86401-4617
(928) 753-2106
(928) 753-4283
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
532
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410036220
RAILROAD MEDICARE
AZ
Enumeration date
11/15/2005
Last updated
12/22/2010
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