Individual
JOHN G MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D O
Contact information
Practice address
3500 CAMP BOWIE BOULEVARD, FORT WORTH, TX 76107-2644
(817) 735-2000
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
H5933
TX
2083A0100X
Aerospace Medicine Physician
H5933
TX
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
H5933
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132677904
—
TX
01
—
8F3682
BLUE CROSS BLUE SHIELD
TX
01
—
P00657642
RAILROAD MEDICARE
TX
Enumeration date
06/23/2005
Last updated
02/19/2009
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