Provider Demographics
NPI:1902905714
Name:MCMULLIN, KARL T (NP)
Entity Type:Individual
Prefix:MR
First Name:KARL
Middle Name:T
Last Name:MCMULLIN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:1240 E 100 S STE 14
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-3005
Mailing Address - Country:US
Mailing Address - Phone:435-628-8232
Mailing Address - Fax:435-674-7994
Practice Address - Street 1:1240 E 100 S STE 14
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-3005
Practice Address - Country:US
Practice Address - Phone:435-628-8232
Practice Address - Fax:435-674-7994
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT175442-44052080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine