Individual
DR. J. WAYNE MCMILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
124 BROOKSIDE LANE, BECKLEY, WV 25801
(304) 255-9205
Mailing address
PO BOX 635007, CINCINNATI, OH 45263-5007
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
12182
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1005325
WORKERS COMP
WV
01
—
93302
UNICARE HMO
WV
05
—
PENDING
—
WV
Enumeration date
06/15/2006
Last updated
11/09/2007
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