Individual
JONATHAN DAYNE MULLINAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
156 FOSTER DR STE B, MCDONOUGH, GA 30253-5346
(770) 506-4119
(770) 506-4145
Mailing address
156 FOSTER DR STE B, MCDONOUGH, GA 30253-5346
(770) 506-4119
(770) 506-4145
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14067
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/16/2024
Last updated
06/04/2026
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