Organization
FRED L MCMILLAN, MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRED L MCMILLAN MD (OWNER)
(601) 948-6886
Entity
Organization
Contact information
Practice address
1421 N STATE ST, SUITE 503, JACKSON, MS 39202-1658
(601) 948-6886
(601) 948-7044
Mailing address
1421 N STATE ST, SUITE 503, JACKSON, MS 39202-1658
(601) 948-6886
(601) 948-7044
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
05468
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015679
—
MS
Enumeration date
12/05/2007
Last updated
04/10/2008
Update your record
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