Michael R. Mcmullan
Interventional Cardiology Internist - Cardiovascular Disease
2500 N State St Division Of Cardiology
Jackson
, Mississippi 39216-4500
Michael R. Mcmullan
Interventional Cardiology Internist - Cardiovascular Disease
2500 N State St Division Of Cardiology
Jackson
, Mississippi 39216-4500
(601) 984-6439
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About
Features
Specialties
- Internist - Cardiovascular Disease
- Interventional Cardiology
Languages spoken
- English
Location
First Address
- Michael R. Mcmullan
- 2500 N State St
- Jackson, MS
- Zip : 39216-4500
- Fax : (601) 984-6439
- Phone : (601) 984-5640
Second Address
- Michael R. Mcmullan
- 2500 N State St Division Of Cardiology
- Jackson, MS
- Zip : 39216-4500
- Fax : (601) 984-6439
- Phone : (601) 984-6426
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RC0000X | Internist - Cardiovascular Disease | 13195 | MS |
| Y | 207RI0011X | Interventional Cardiology | 13195 | MS |
National Provider Identifier
| NPI | 1104857036 |
|---|---|
| Provider Name | Michael R. Mcmullan |
| First Address | Jackson, MS 39216-4500 |
| Second Address | Jackson, MS 39216-4500 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/07/2006 |
| Last Update Date | 24/01/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0119549 | (05) | MS |
| G29240 | (02) | MS |
| P01402426 | RR MEDICARE (01) | MS |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.