Basic Information
| Provider Information | |||||||||
| NPI: | 1508846833 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MULLINS-HODGIN | ||||||||
| FirstName: | RITA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 60447 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282600447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3365644866 | ||||||||
| FaxNumber: | 3365644869 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 CLINIC DR | ||||||||
| Address2: | |||||||||
| City: | TARBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278861935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2528232105 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2006 | ||||||||
| LastUpdateDate: | 10/25/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 9900305 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 9900305 | NC | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207QA0000X | 9900305 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine | Adolescent Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0457197 | 01 | NC | UNITED HEALTHCARE | OTHER | 128V7 | 01 | NC | BCBS | OTHER | 110219164 | 01 | NC | RAILROAD MEDICARE | OTHER | A7139 | 01 | NC | MEDCOST | OTHER | 89128V7 | 05 | NC | MEDICAID |