Individual
DR. JACK RICHARD MILLARD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 POMFRET ST, DEPARTMENT OF RADIOLOGY, PUTNAM, CT 06260-1836
(860) 963-6356
(860) 963-6335
Mailing address
25 ROCKY POND RD, BOYLSTON, MA 01505-1511
(860) 963-6356
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
15156
CT
Other
Enumeration date
12/21/2005
Last updated
07/08/2007
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