Organization
MARILYN MASON MCMILLEN MD PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN MASON MCMILLEN MD (PRESIDENT)
(606) 678-8800
Entity
Organization
Contact information
Practice address
305 LANGDON ST, SOMERSET, KY 42501
(606) 678-8800
(606) 679-5238
Mailing address
PO BOX 3310, W SOMERSET, KY 42564
(606) 678-8800
(606) 679-5238
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220031591
MEDICARE RAILROAD
KY
05
—
65928145
—
KY
Enumeration date
03/28/2006
Last updated
05/08/2013
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