Provider Demographics
NPI:1548535354
Name:MULLINS, BETHANY (DO)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:MULLINS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 S CHAMBERS RD
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-9498
Mailing Address - Country:US
Mailing Address - Phone:720-875-2880
Mailing Address - Fax:
Practice Address - Street 1:8401 S CHAMBERS RD
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9498
Practice Address - Country:US
Practice Address - Phone:720-875-2880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL.0004888207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine