Individual
TERRY Y MCMILLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
203 9TH ST, GREENWOOD, MS 38930-4015
(662) 459-1367
(662) 459-1368
Mailing address
203 9TH ST, GREENWOOD, MS 38930-4015
(662) 459-1367
(662) 459-1368
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
207V00000X
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117104
—
MS
01
—
13194
STATE LICENSING
MS
Enumeration date
07/07/2006
Last updated
07/07/2011
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