Individual
DR. THEODORE MICHAEL MILLETTE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
4105 HOSPITAL ST, STE 103, PASCAGOULA, MS 39581-5312
(228) 762-8712
(228) 762-2261
Mailing address
4105 HOSPITAL ST, STE 103, PASCAGOULA, MS 39581-5312
(228) 762-8712
(228) 762-2261
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
09156
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00016711
—
MS
01
—
0005309051
AETNA
MS
Enumeration date
03/08/2006
Last updated
07/08/2007
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