MR. DOUGLAS WAYNE MULLIN C.O. NPI 1316051006

NPI Information

NPI: 1316051006
Provider Name: MR. DOUGLAS WAYNE MULLIN, C.O.
Classification: Specialist - 1744P3200X
Entity Type: Individual

Specialization: Prosthetics Case Management

Address:
3802 AMELIA AVE
SUITE B
LAFAYETTE, IN
ZIP 47905
Phone: (765) 404-7285
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MR. Douglas Wayne Mullin, C.O. is a prosthetics case management specialist in Lafayette, IN. MR. Douglas Wayne Mullin, C.O. NPI is 1316051006. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3802 AMELIA AVE
SUITE B
LAFAYETTE, IN
ZIP 47905-772
Phone: (765) 404-7285

The enumeration date for this NPI number is 8/18/2006 and was last updated on 12/19/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1744P3200X	Specialist	Prosthetics Case Management	15097	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4148480002	MEDICARE PIN	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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