Individual
MR. JOHN R MCMULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
333 N 17TH DR, PHOENIX, AZ 85007-2423
(480) 278-2100
Mailing address
333 N 17TH DR, PHOENIX, AZ 85007-2423
(480) 278-2100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3613
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3613
PA LICENSE
AZ
Enumeration date
10/05/2006
Last updated
09/24/2013
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