Individual
DR. DANIEL C MACMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 GORDON GUTMANN BLVD STE 401, JEFFERSONVILLE, IN 47130-3768
(812) 282-0637
(812) 283-6330
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01045231A
IN
208600000X
Surgery Physician
1045231
IN
208600000X
Surgery Physician
28148
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01045231A
STATE ID #
IN
01
—
01045231B
CONTROLLED SUBSTANCE REG
IN
05
—
200084530
—
IN
01
—
28148
STATE LICENSE
KY
05
—
7100952390
—
KY
Enumeration date
09/13/2005
Last updated
02/23/2024
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