# MCMILLAN CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Hand Specialists
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114944634
- **Authorized official:** MR. CHARLES L MCMILLAN JR. (PRESIDENT/OWNER)
- **Authorized official phone:** (985) 674-4170

## Contact information

- **Practice address:** 594 ASBURY DR, STE A, MANDEVILLE, LA 70471
- **Practice address phone:** (985) 674-4170
- **Practice address fax:** (985) 674-4172
- **Mailing address:** 594 ASBURY DR, STE A, MANDEVILLE, LA 70471-4101
- **Mailing address phone:** (985) 674-4170
- **Mailing address fax:** (985) 674-4172

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | — | NULL | Yes |
| 225X00000X | Occupational Therapist | — | — | Yes |

## Other

- **Enumeration date:** 07/17/2006
- **Last updated:** 05/17/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5CQ94 | MEDICARE PROVIDER NUMBER/PTAN | LA |