| Doctor Name: | JASON WESLEY MULLINS |
| NPI Number: | 1699146100 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | TC430 |
| Business Practice Address: | 4004 Louisa Road Catlettsburg, KY - 411291091 |
| Business Phone Number: | 6067396095 |
| Business Fax Number: | 6067398252 |
| Mailing Address: | P. O. Box 1595, ASHLAND |
| State: | KY |
| Postal Code: | 411051595 |
| Phone Number: | 6064086200 |
| Fax Number: | 6064086612 |
| NPI Enumeration Date: | 10/09/2015 |
| NPI Last Update Date: | 10/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | TC430 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |