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Individual

JEFFREY T MACMILLAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
255 W 4TH ST, KIMBALL, NE 69145-1706
(308) 235-1951
Mailing address
PO BOX 920, TORRINGTON, WY 82240-0920
(913) 894-2121
(913) 894-9592

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
04-25519
KS
207X00000X
Orthopaedic Surgery Physician
Primary
29753
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0982140
UNITED HEALTHCARE
KS
05
100171940A
KS
01
141094900
US DEPARTMENT OF LABOR
KS
01
15076140
HUMANA
KS
01
200030413
RR MEDICARE
KS
05
208162701
MO
01
21793010
BCBS KC
KS
01
431793993
TRIWEST
KS
Enumeration date
07/26/2006
Last updated
08/16/2024
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