| Doctor Name: | MRS. TABITHA HENDRIX MULLIS |
| NPI Number: | 1013329846 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | RN167847 |
| Business Practice Address: | 360 Hospital Drive Bldg D Suite 130 Macon, GA - 312178054 |
| Business Phone Number: | 4784640035 |
| Business Fax Number: | 4784640038 |
| Mailing Address: | 360 Hospital Drive, Bldg D. Suite 130 MACON |
| State: | GA |
| Postal Code: | 312178054 |
| Phone Number: | 4784640035 |
| Fax Number: | 4784640038 |
| NPI Enumeration Date: | 05/28/2014 |
| NPI Last Update Date: | 04/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN167847 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |