CAROLYN T MALLILLIN (MD) – Family Medicine Physician, NPI 1194719971
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CAROLYN T MALLILLIN (MD)
174 CHINA BLUE LN
CAPE GIRARDEAU, MO 637013800
Phone:
Type: Mailing
1900 BLUEGRASS AVE STE 300
LOUISVILLE, KY 402151183
Phone: (502) 361-1222
Type: Location
John J. Pershing VA Medical Center, 1500, North Westwood Boulevard, Poplar Bluff, Butler County, Missouri, 63901, United States
POPLAR BLUFF, MO 639013318
Phone: (573) 686-4151
Type: Mailing
1500 N Westwood Blvd
Poplar Bluff, MO 639013318
Phone: (573) 686-4151
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-05-06
PECOS data refreshed: 2026-05-27
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Medicare Utilization (FFS)
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Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63701)
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