Individual
DR. GERALD W. MCMULLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
922 S MAIN ST, KINGFISHER, OK 73750-4416
(405) 375-3128
(405) 375-3134
Mailing address
922 S MAIN ST, KINGFISHER, OK 73750-4416
(405) 375-3128
(405) 375-3134
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
996
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100766080A
—
OK
01
—
730941249-001
BLUE CROSS/BLUE SHIELD
OK
Enumeration date
08/15/2006
Last updated
09/10/2008
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