Tiffany Mullen, DO | |
325 E. Silver Spring Drive, Whitefish Bay, WI 53217-5222 | |
(414) 247-4800 | |
(414) 247-4801 |
Full Name | Tiffany Mullen |
---|---|
Gender | Female |
Speciality | Family Medicine |
Location | 325 E. Silver Spring Drive, Whitefish Bay, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760599187 | NPI | - | NPPES |
P00784994 | Other | WI | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 47814 (Wisconsin) | Primary |
Entity Name | Active Wellness Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902162662 PECOS PAC ID: 3072752864 Enrollment ID: O20130627000369 |
Mailing Address | Practice Location Address |
---|---|
Tiffany Mullen, DO 3003 W. Good Hope Road, Milwaukee, WI 53209 Ph: (414) 352-3100 | Tiffany Mullen, DO 325 E. Silver Spring Drive, Whitefish Bay, WI 53217-5222 Ph: (414) 247-4800 |
Steven J Heyden, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 325 E Silver Spring Dr, Whitefish Bay, WI 53217 Phone: 414-247-4800 | |
Megan E Singer, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 325 E Silver Spring Dr, Whitefish Bay, WI 53217 Phone: 414-247-4800 Fax: 414-247-4801 | |
John Andrew Kim, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 325 E Silver Spring Dr, Whitefish Bay, WI 53217 Phone: 414-247-4800 | |
Claire E Inda, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 325 E Silver Spring Dr, Whitefish Bay, WI 53217 Phone: 414-247-4800 Fax: 414-247-4801 | |
Marc A Olsen, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 325 E Silver Spring Dr, Whitefish Bay, WI 53217 Phone: 414-247-4800 Fax: 414-247-4801 |