Individual
DAMON C. MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1720 S GADSDEN ST, TALLAHASSEE, FL 32301-5506
(850) 576-4073
(850) 576-2824
Mailing address
1720 S GADSDEN ST, TALLAHASSEE, FL 32301-5506
(850) 576-4073
(850) 576-2824
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME76689
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162001
HEALTHEASE OF FLORIDA#1
FL
01
—
209999
HEALTHEASE FLORIDA #2
FL
05
—
255569700
—
FL
01
—
5399
BC/BS OF FLORIDA
FL
01
—
SG075553
VISTA (MEDICAID)
FL
Enumeration date
02/09/2006
Last updated
10/15/2010
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