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Mullick Dermatology, PLLC

Dermatology in Germantown, TN. Organization (NPI-2).

NPI number1154862217
StatusActive
Last updated in NPPESJul 27, 2022

Details

NPI
1154862217
Entity type
Organization (NPI-2)
Legal business name
Mullick Dermatology, PLLC
Organization subpart
No
Enumeration date
Mar 9, 2017
Certification date
Jul 27, 2022
Last updated
Jul 27, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207N00000X DermatologyMD49897TNYes

Practice location

3036 Centre Oak Way
Germantown, TN 38138-6302

Phone 901-572-0005

Mailing address

Po Box 758
Paris, TN 38242-0758

Phone 901-572-0005

Other practice locations

9760 Lipsey Cv
Germantown, TN 38139-8076

Phone 901-277-3534

Authorized official

Suparna Mullick
President
9015720005

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