Provider Demographics
NPI:1336904077
Name:MCMILLIAN EYE CARE
Entity type:Organization
Organization Name:MCMILLIAN EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCMILLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-840-3937
Mailing Address - Street 1:185 WESLEY REED DR STE E
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:TN
Mailing Address - Zip Code:38004-4955
Mailing Address - Country:US
Mailing Address - Phone:901-840-3937
Mailing Address - Fax:901-840-3395
Practice Address - Street 1:185 WESLEY REED DR STE E
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:TN
Practice Address - Zip Code:38004-4955
Practice Address - Country:US
Practice Address - Phone:901-840-3937
Practice Address - Fax:901-840-3395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1194701110OtherNPI
TN1518459775OtherNPI