NPIMap

Organization Active NPI

Mullis Eye Institute Inc

  • Optometrist
  • Marianna, FL
National Provider Identifier
1073647848
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ME0027750 Issued in FL
Legal business name
MULLIS EYE INSTITUTE INC
Practice address
4320 5TH Ave
Marianna, FL 32446-2182
Phone
(850) 526-7775
Fax
(850) 763-6665
NPI assigned
Mar 15, 2007
Organization subpart
Yes
Parent organization
MULLIS EYE INSTITUTE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Authorized official

Name
O. Lee Mullis, MD
Title
President
Phone
(850) 763-6666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X ME0027750 FL Primary

Addresses

Primary practice location

4320 5TH Ave
Marianna, FL 32446-2182

Mailing address

1600 Jenks Ave
Panama City, FL 32405-4644
Phone (850) 763-6666

National Provider Directory

National Provider Directory
Tax ID family
Mullis Eye Institute4 organizations share this tax ID, including this one
Part of
Mullis Eye Institute

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1073647848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054644",
            "telephone_number": "850-763-6666",
            "fax_number": "850-763-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 5TH AVE",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462182",
            "telephone_number": "850-526-7775",
            "fax_number": "850-763-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULLIS EYE INSTITUTE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MULLIS EYE INSTITUTE, INC",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "MULLIS",
        "authorized_official_first_name": "O.",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-763-6666",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "ME0027750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marianna, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.