Individual
JUSTIN GERARD MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1440 HAWTHORNE AVE, COLUMBUS, OH 43203-1665
(937) 789-3423
Mailing address
PO BOX 2026, FAIRBORN, OH 45324-8026
(937) 751-7477
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35050604
OH
2085R0001X
Radiation Oncology Physician
Primary
35-05-0604-M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0558338
—
OH
Enumeration date
06/17/2005
Last updated
03/07/2023
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