JOHN P. MULLALLY MD – NPI #1033105630
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

JOHN MULLALLY is a physician located in PORT HURON, MI. NPPES has assigned the NPI number 1033105630 to JOHN MULLALLY on September 20, 2005. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 19 years ago on Oct 17, 2007. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JOHN MULLALLY below.

NPI Profile for
JOHN P. MULLALLY

NPI Number
1033105630
Enumeration Date

(more than 20 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
JOHN P. MULLALLY
Credentials
MD
Primary location
1117 STONE ST
SUITE 2
PORT HURON, MI 48060
Phone: (810) 966-4540 Fax: (810) 966-4549
Mailing address
Same as primary location
Sole Proprietor
Yes
Updated
Identifiers

Identifiers for JOHN MULLALLY

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERBCBSMI0740124
OTHERCARE CHOICESMI104299
OTHERHAPMIG13412
MEDICAIDMI4352066
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)		 MI 4301059921

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Additional Information

Education
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE - Graduated 1992
Offers Telehealth Services
Yes - Telehealth services allows you to talk to your health care provider using audio/video communications, such as Zoom, without actually going in to the doctor's office
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices
Affiliations
JOHN MULLALLY is affiliated with the following medical group(s):
  • HOSPITAL
    • ASCENSION RIVER DISTRICT HOSPITAL
      4100 RIVER RD
      EAST CHINA, MI 48054
    • LAKE HURON MEDICAL CENTER
      2601 ELECTRIC AVENUE
      PORT HURON, MI 48060
    • MCLAREN PORT HURON
      1221 PINE GROVE AVE
      PORT HURON, MI 48060
  • HOME HEALTH AGENCY
    • FLAGSTAR HOME HEALTH SERVICES
      27427 SCHOENHERR ROAD, SUITE 400
      WARREN, MI 48088
    • MCLAREN HOME HEALTH
      12900 HALL ROAD, SUITE 200
      STERLING HEIGHTS, MI 48313
  • NURSING HOME
    • MARWOOD MANOR NURSING HOME
      1300 BEARD ST
      PORT HURON, MI 48060
    • MEDILODGE OF PORT HURON
      5635 LAKESHORE
      FORT GRATIOT, MI 48059
    • REGENCY ON THE LAKE - FORT GRATIOT
      5669 LAKESHORE
      FORT GRATIOT, MI 48059

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