DR. ERIC MULLEN (NPI# 1164481321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164481321 |
| Entity Type | Individual |
| Full Name | DR. ERIC MULLEN |
| Credential | M.D. |
| Practice Address |
1111 Crater Lake Ave Medford OR 97504-6241 |
| Mailing Address |
Po Box 8509 Medford OR 97501-5009 |
| Practice Telephone | 5417327000 |
| Mailing Telephone | 5417720023 |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2010-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
MD25020 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 022459 | 05 | |
| OR | OREGON STATE LICENSE | MD25020 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194182097 | Eric Mullen | Counselor | 5 Stowman Dr, Ewing, NJ 08618-1826 | 2016-01-22 |
| Street Address |
1111 CRATER LAKE AVE |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-6241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558361378 | Craig S. Thalacker | Emergency Medicine | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2005-07-22 |
| 1447865464 | Annabel M Walker | Nurse Practitioner | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2020-09-15 |
| 1386256519 | Ryan Tierney | Physical Therapist | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2020-08-19 |
| 1992362867 | Courtney Howarth | Physical Therapy Assistant | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2019-05-24 |
| 1811470107 | Nicole Marie Choyce | Dietitian, Registered | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2018-09-12 |
| 1336621721 | Tai Bailey Shelton | Physical Therapist | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2018-08-31 |
| 1932681533 | Jacqueline Lucas-morris | Occupational Therapist | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2018-08-30 |
| 1477035236 | Sarah Rae Hanley | Occupational Therapist | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2018-08-29 |
| 1306327242 | Elizabeth Carlton | Physical Therapist | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2018-08-28 |
| 1851872428 | Ida Marielke Funke | Physical Therapist | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2018-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972751493 | Todd Christopher Adams | Radiology | 128 Washington St, Medford, MA 02155-4741 | 2008-09-09 |
| 1104082577 | Cancer Care of Southern Oregon | Radiology | 2900 Doctors Park Dr, Medford, OR 97504-8198 | 2008-08-05 |
| 1649239435 | Gordon Metz | Radiology | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2006-03-21 |
| 1942269170 | Craig Haveman | Radiology | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2006-03-17 |
| 1396714515 | Radiation Oncology Group Consultants, PC | Radiology | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2006-03-17 |
| 1790744928 | Jere Sandefur | Radiology | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2006-03-17 |
| 1710946959 | Kenneth Haugen | Radiology | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2006-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417501420 | Oarm Services of Oregon PC | Radiology | 1713 Sw 24th St, Pendleton, OR 97801-4330 | 2019-07-29 |
| 1235549031 | Amar Srivastava | Radiology | 4805 Ne Glisan St, Garden Level, Portland, OR 97213 | 2014-05-01 |
| 1962848655 | Joshua M Walker | Radiology | 3181 Sw Sam Jackson Park Rd # Kpv4, Portland, OR 97239 | 2013-05-21 |
| 1740596105 | Kevin Forsythe | Radiology | 1457 G St, Springfield, OR 97477-4113 | 2010-08-24 |
| 1578610382 | Jerry Jeff Jaboin | Radiology | 3181 Sw Sam Jackson Park Rd # L337, Department of Radiation Medicine, Portland, OR 97239-3011 | 2007-01-04 |
| 1952467607 | Jerald Edward Albrich | Radiology | 2389 N Maple St, Canby, OR 97013-2106 | 2006-12-28 |
| 1427139120 | Radiation Therapy Consultants, PC | Radiology | 875 Oak St Se Ste 1080, Salem, OR 97301-3977 | 2006-10-18 |
| 1982702221 | Margaret J Thompson | Radiology | 12990 W Perrydale Rd, Amity, OR 97101-9519 | 2006-09-20 |
| 1881631745 | Grace E Yuh | Radiology | 2700 Se Stratus Ave Ste A, Mcminnville, OR 97128-6258 | 2006-06-01 |
| 1770520892 | Katie Anne Deming | Radiology | 1400 Nw Irving St, 527, Portland, OR 97209-2210 | 2006-05-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.