Provider Demographics
NPI:1285914721
Name:MULLINS, JAMES DAVID (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:MULLINS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:MULLINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:11930 STANDIFORD PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-5901
Mailing Address - Country:US
Mailing Address - Phone:502-961-5843
Mailing Address - Fax:502-961-5847
Practice Address - Street 1:11930 STANDIFORD PLAZA DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40229-5901
Practice Address - Country:US
Practice Address - Phone:502-961-5843
Practice Address - Fax:502-961-5847
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-27
Last Update Date:2011-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014213183500000X
OH03-3-28808183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist