Healthcare Provider Details

I. General information

NPI: 1386631075
Provider Name (Legal Business Name): GREGORY TODD MILROY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 HARMONY XING STE 5
EATONTON GA
31024-9546
US

IV. Provider business mailing address

803 S MAIN ST
GREENSBORO GA
30642-1211
US

V. Phone/Fax

Practice location:
  • Phone: 706-454-1210
  • Fax: 706-454-1211
Mailing address:
  • Phone: 706-453-1201
  • Fax: 706-454-0337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number111384
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: