Provider Demographics
NPI:1174743918
Name:MULLIS, THOMAS CORBIN (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:CORBIN
Last Name:MULLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:102 FAIRVIEW PARK DR
Mailing Address - Street 2:DUBLIN ENT ASSOCIATES
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-2500
Mailing Address - Country:US
Mailing Address - Phone:478-272-8382
Mailing Address - Fax:478-272-8464
Practice Address - Street 1:102 FAIRVIEW PARK DR
Practice Address - Street 2:DUBLIN ENT ASSOCIATES
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2500
Practice Address - Country:US
Practice Address - Phone:478-272-8382
Practice Address - Fax:478-275-1964
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS19375207Y00000X
GA060771207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology