Individual
KELLY LYLES MCMILLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 EAGLE RIDGE DR, BIRMINGHAM, AL 35242-5319
(205) 995-1004
(205) 991-6075
Mailing address
101 EAGLE RIDGE DR, BIRMINGHAM, AL 35242-5319
(205) 995-1004
(205) 991-6075
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
30655
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000137515
—
AL
01
—
511-23313
BCBS OF ALABAMA
—
Enumeration date
04/29/2009
Last updated
01/04/2016
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