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NPI Code Detail

MEDICARE: BARRY DUANE MCMILLON PA-C

MEDICARE: BARRY DUANE MCMILLON PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant2753AZ

General Provider Information

NPI Number : 1457413346
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARRY DUANE MCMILLON PA-C
Provider Business Mailing Address
First Line : 1233 S JOEY PL
Second Line :
City : TUCSON
State : AZ
Zip : 85713-1158
Country : US
Telephone Number : 520-240-3694
Fax Number :
Provider Business Practice Location Address
First Line : 39580 S LAGO DEL ORO PKWY
Second Line :
City : TUCSON
State : AZ
Zip : 85739-1091
Country : US
Telephone Number : 520-624-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2006
Last Update Date : 07/08/2007

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Directions to “ BARRY DUANE MCMILLON PA-C” Practice Location

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