Bruce Roger McMullen, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0418744 Issued in KS

Practice address

1122 South Clifton
Wichita, KS 67218-2913

Phone

(316) 682-5012

Fax

(316) 652-9510

NPI assigned

Apr 1, 2006

Last updated

Jan 8, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262908800000",
    "number": "1073574562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 SOUTH CLIFTON",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672182913",
            "telephone_number": "316-682-5012",
            "fax_number": "316-652-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 SOUTH CLIFTON",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672182913",
            "telephone_number": "316-682-5012",
            "fax_number": "316-652-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "BRUCE",
        "middle_name": "ROGER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-01",
        "last_updated": "2010-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "0418744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MED",
            "identifier": "110004044",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INS",
            "identifier": "0004084117",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100199260B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara J McMillan, CRNA
• Cynthia McMillin, ARNP
• Lisa Kara McMillin, RN
• Tyler McMillin
• Kimberly McMinn-Rogers
• Lauren McMullen, PA-C
• Karen McNally, LMSW
• Kayla McNany, LPN
• Chyane McNeal
• Kristi R McNeal, LSCSW

• Internal Medicine Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Internal Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.