Healthcare Provider Details

I. General information

NPI: 1417395245
Provider Name (Legal Business Name): DAVID SAMUEL JOSEPH MILLAY MD, OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2013
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5955 ZEAMER AVE
JBER AK
99506-3702
US

IV. Provider business mailing address

5955 ZEAMER AVE
JBER AK
99506-3702
US

V. Phone/Fax

Practice location:
  • Phone: 907-580-5804
  • Fax: 907-580-5520
Mailing address:
  • Phone: 907-580-5804
  • Fax: 907-580-5520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18003793A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number0101277920
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: