Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TIMOTHY JAMES MULLALLY, DO
ActiveTIMOTHY JAMES MULLALLY, DO is a Sports Medicine healthcare provider located in CROWN POINT, Indiana. NPI 1366462046 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine · CROWN POINT, IN
Registration Details
- NPI Number
- 1366462046
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 19, 2006 (20.062082128813 yrs)
- Last Updated
- Mar 25, 2019
- Licenses
-
02003099A (IN)02003099A (IN)
Practice Information
- Address
-
11275 DELAWARE PKWYCROWN POINT, IN, 463077812Browse IN providers · Browse ZIP 46307
- Phone
- 2197798735
- Fax
- 8777152312
- Primary Specialty
-
Sports Medicine
207QS0010X
- Additional Specialty
- Family Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.