Healthcare Provider Details

I. General information

NPI: 1730718453
Provider Name (Legal Business Name): MATTHEW FREDERICK MILLS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2020
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6071 E WOODMEN RD STE 200
COLORADO SPRINGS CO
80923-2609
US

IV. Provider business mailing address

6071 E WOODMEN RD STE 200
COLORADO SPRINGS CO
80923-2609
US

V. Phone/Fax

Practice location:
  • Phone: 720-712-0300
  • Fax:
Mailing address:
  • Phone: 719-212-2108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDR.0073813
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: