Organization
JEFFREY T MACMILLAN MD PA
Active
Other names
JEFFREY T MACMILLAN MD PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY T MACMILLAN MD (OWNER)
(913) 894-2121
Entity
Organization
Contact information
Practice address
12200 W 106TH ST, OVERLAND PARK, KS 66215-2300
(913) 894-2121
(913) 894-9592
Mailing address
9119 W 74TH ST, SUITE 354, MERRIAM, KS 66204-2215
(913) 894-2121
(913) 894-9592
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
04-25519
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100171940A
—
KS
01
—
200030413
MEDICARE RR
KS
05
—
208162701
—
MO
01
—
21793020
BCBS KC
KS
01
—
DG2851
RR MEDICARE GROUP #
KS
Enumeration date
10/12/2006
Last updated
10/08/2008
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