Individual
STEPHEN ELI MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
79 MAPLE DR, PLATTE CITY, MO 64079-9640
(816) 858-3954
(816) 858-3954
Mailing address
79 MAPLE DR, PO BOX 1008, PLATTE CITY, MO 64079-9640
(816) 858-3954
(816) 858-3954
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046009712
IL
152W00000X
Optometrist
Primary
2004018249
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
319083408
—
MO
Enumeration date
07/19/2006
Last updated
07/09/2007
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