Mulberry Medical, LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

10658 Issued in AL

Legal business name

MULBERRY MEDICAL, LLC

Practice address

2100 Chestnut St
Montgomery, AL 36106-1113

Phone

(334) 676-4090

Fax

(334) 676-4091

NPI assigned

Oct 24, 2016

Organization subpart

No

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

Authorized official

Name

Kynard L Adams, M.D.

Title

Owner

Phone

(334) 264-3434

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1295286300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CHESTNUT ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061113",
            "telephone_number": "334-676-4090",
            "fax_number": "334-676-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CHESTNUT ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061113",
            "telephone_number": "334-676-4090",
            "fax_number": "334-676-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULBERRY MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "KYNARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-264-3434",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "AL",
            "license": "10658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raghu Mukkamala, MD
• Rama Lakshmi Mukkamala, MD
• Mulberry Diagnostic Imaging
• Mulberry Foot Care, LLC
• Mulberry Medical Associates, P.C
• Mulberry Wellness Salon LLC
• Michael Brandon Mull, O.D
• Allan Muller, DO
• Corazon Mulles, MD
• Jason Graham Mullins Jr., D.M.D.

• Point of Service in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Point of Service in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.