Individual
PATRICK EDWARD MACMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
101 S MAIN ST, ROGERSVILLE, MO 65742-9357
(417) 753-9404
(417) 753-9137
Mailing address
101 S MAIN ST, ROGERSVILLE, MO 65742-9357
(417) 753-9404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R2H29
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
242498541
—
MO
01
—
26111
BLUE CROSS BLUE SHIELD
MO
Enumeration date
09/27/2006
Last updated
08/17/2022
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