Individual
DR. MARK J MILNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 E PRIMROSE ST, SPRINGFIELD, MO 65807-5155
(417) 875-3000
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 875-3000
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
17653
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107723
BLUE CROSS MO
—
05
—
1538251889
—
MO
05
—
208654400
—
MO
Enumeration date
09/28/2006
Last updated
07/08/2014
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