Individual
DUSTIN LANCE MILLICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1007 GOODYEAR AVE, GADSDEN, AL 35903-1195
(256) 494-4768
(256) 494-4793
Mailing address
1007 GOODYEAR AVE, GADSDEN, AL 35903-1195
(256) 494-4768
(256) 494-4793
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
L3459.R
AL
207Q00000X
Family Medicine Physician
Primary
MD33517
AL
Other
Enumeration date
07/16/2012
Last updated
07/23/2014
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