Provider Demographics
NPI:1124648761
Name:MULLINS, AARON KEITH (OD)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:KEITH
Last Name:MULLINS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2136 ELKHORN CRK
Mailing Address - Street 2:
Mailing Address - City:ELKHORN CITY
Mailing Address - State:KY
Mailing Address - Zip Code:41522-7115
Mailing Address - Country:US
Mailing Address - Phone:606-253-2918
Mailing Address - Fax:
Practice Address - Street 1:225 HOSPITAL DR STE 160
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-7635
Practice Address - Country:US
Practice Address - Phone:859-744-4429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2208DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist