Individual
MR. IAN S MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2712 LAWRENCEVILLE HWY, DECATUR, GA 30033-2512
(770) 496-5555
(770) 939-2887
Mailing address
1835 SAVOY DR, SUITE 300, ATLANTA, GA 30341-1072
(770) 496-5555
(770) 939-2887
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004760
GA
363AM0700X
Medical Physician Assistant
4760
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153442161K
—
GA
Enumeration date
05/23/2006
Last updated
08/18/2020
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