Mullis, Jonathan T

Mullis, Jonathan T is an individual health care provider with primary practice located at 1600 Forsyth St , Macon GA 31201-1408. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Mullis, Jonathan T can be contacted via phone (478) 743-3000.

Contact Information

Primary practice address
1600 Forsyth St Macon GA 31201-1408
Phone: (478) 743-3000
Fax: (478) 741-9657
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 005099 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 005099 Georgia

Profile Details

NPI number 1396945135
LBN Legal business name Mullis, Jonathan T
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2007
Last updated Aug 27th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396945135 NPPES
Georgia MEDICAID 960643386A
Georgia Other 005099

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