Provider Demographics
NPI:1124111273
Name:MULLIGAN, ERIKA A (DO)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:A
Last Name:MULLIGAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WOODMONT BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5250
Mailing Address - Country:US
Mailing Address - Phone:888-987-1151
Mailing Address - Fax:
Practice Address - Street 1:2210 MAIN STREET
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698
Practice Address - Country:US
Practice Address - Phone:727-615-3133
Practice Address - Fax:727-615-2194
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006728207R00000X
FLOS21844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2075981Medicaid
OH2075981Medicaid
OH0858104Medicare PIN