Provider Demographics
NPI:1699772723
Name:MILLS, ALLAN DAVID (MD)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:DAVID
Last Name:MILLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761B MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-1715
Mailing Address - Country:US
Mailing Address - Phone:251-928-4750
Mailing Address - Fax:251-990-2560
Practice Address - Street 1:761B MIDDLE ST
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-1715
Practice Address - Country:US
Practice Address - Phone:251-928-4750
Practice Address - Fax:251-990-2560
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALACS161002084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51033707OtherB/C
AL000033707Medicaid
E92626Medicare UPIN
AL000033707Medicare ID - Type Unspecified