Provider Demographics
NPI:1316130073
Name:MULLINS VISION ASSOCIATES,PLLC
Entity type:Organization
Organization Name:MULLINS VISION ASSOCIATES,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:931-526-6711
Mailing Address - Street 1:585 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-1886
Mailing Address - Country:US
Mailing Address - Phone:931-526-6711
Mailing Address - Fax:931-526-6712
Practice Address - Street 1:585 E 10TH ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-1886
Practice Address - Country:US
Practice Address - Phone:931-526-6711
Practice Address - Fax:931-526-6712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN323688OtherUNITED HEALTHCARE
4152782OtherBLUE CROSS BLUE SHIELD
53884OtherDAVIS VISION
TN5914460001Medicare NSC
TN3370102Medicare PIN