NPIMap

Organization Active NPI

Mullis Eye Institute Inc

  • Specialist
  • Panama City, FL
National Provider Identifier
1750497012
Registry record updated Mar 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MULLIS EYE INSTITUTE INC
Practice address
1600 Jenks Ave
Panama City, FL 32405-4644
Phone
(850) 763-6666
Fax
(850) 763-6665
NPI assigned
Aug 21, 2006
Organization subpart
Yes
Parent organization
MULLIS EYE INSTITUTE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 20, 2009

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

Authorized official

Name
Oscar Mullis, M.D.
Title
President
Phone
(850) 763-6666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1600 Jenks Ave
Panama City, FL 32405-4644

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
251263700MedicaidFL
301351100MedicaidFL

Other names 1

  • Physician Group Other name

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.

Locations

1600 Jenks Ave
Panama City, FL 32405
Phone (850) 381-2616

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237507200000",
    "number": "1750497012",
    "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": "1600 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054644",
            "telephone_number": "850-763-6666",
            "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": "2006-08-21",
        "last_updated": "2009-03-20",
        "status": "A",
        "authorized_official_last_name": "MULLIS",
        "authorized_official_first_name": "OSCAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-763-6666",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251263700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301351100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physician Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2009; 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.