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Individual

MR. MARK A. MILLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
3465 MACON RD, STE D, COLUMBUS, GA 31907-2582
(706) 243-3051
(706) 243-2027
Mailing address
6600 VAN AALST BLVD BLDG 9250, FORT BENNING, GA 31905-2102
(706) 544-2625
(762) 408-8154

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002938
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100001639C
GA
05
174759447A
GA
01
202I975249
MEDICARE PTAN
GA
01
970009967
RAIL ROAD MEDICARE
GA
Enumeration date
02/01/2007
Last updated
12/30/2025
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