Provider Demographics
NPI:1962516617
Name:MCMILLAN, MICHAEL DEAN (PA)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DEAN
Last Name:MCMILLAN
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:PO BOX 4072
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76505-4072
Mailing Address - Country:US
Mailing Address - Phone:254-743-0912
Mailing Address - Fax:
Practice Address - Street 1:1901 E. FIRST STREET
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504
Practice Address - Country:US
Practice Address - Phone:254-743-2285
Practice Address - Fax:253-743-0121
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant