Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Dallas Mullock, DO

Individual provider Family Medicine Physician · NPI 1134504012

Dr. Dallas Mullock, DO is a Family Practice in Maryville, Missouri. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 2015, 11 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Missouri.

Years since qualifying
11
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
MO
In the registry since
2015
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

2332 S Main St
Maryville, MO 64468-3622
Phone: (660) 562-2223
Fax: (660) 562-2230
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 2015023403 (MO)

Record details

NPI number1134504012
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 21, 2015
Last updated in NPPESMay 21, 2020
Certification dateMay 21, 2020
Mailing address2332 S Main St, Maryville, MO 64468-3622

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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