Mullis, Jerry
Mullis, Jerry is an individual health care provider with primary practice located at 2100 Riverside Ave , Waycross GA 31501-7020. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Mullis, Jerry can be contacted via phone (912) 490-7777.Contact Information
Primary practice address
2100 Riverside Ave
Waycross GA 31501-7020
Phone: (912) 490-7777
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 42368 | Georgia |
Profile Details
| NPI number | 1851314975 |
|---|---|
| LBN Legal business name | Mullis, Jerry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 26th, 2006 |
| Last updated | Jan 14th, 2026 - about 9 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851314975 | NPPES |
| Georgia | MEDICAID | 000754872D | |
| Georgia | MEDICAID | 000754872H | |
| Georgia | Other | 100165 |
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