Individual
DR. ROBERT DANCY MILLICAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1626 FREDERICA RD, STE101, ST SIMONS ISLAND, GA 31522
(912) 634-5711
(912) 634-5713
Mailing address
1626 FREDERICA RD, STE 101, ST SIMONS ISLAND, GA 31522
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OPT1245
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511G700587
MEDICARE PTAN#
—
Enumeration date
11/16/2006
Last updated
01/09/2013
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