Individual
MICHAEL L MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 N PORTER AVE, NORMAN, OK 73071-6404
(405) 307-1000
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
(660) 826-4852
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
16619
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050085128
RR MEDICARE
OK
05
—
100095830A
—
OK
Enumeration date
12/02/2005
Last updated
10/17/2017
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