Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 25533 | MS |
Y | 207X00000X | Orthopaedic Surgeon | MD.33119 | AL |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 25533 | MS |
NPI | 1699031369 |
---|---|
Provider Name | Dr. Jess Harding Mullens |
First Address | Atlanta, GA 30374-6450 |
Second Address | Mobile, AL 36604-1541 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2012 |
Last Update Date | 26/10/2021 |