Healthcare Provider Details

I. General information

NPI: 1861636458
Provider Name (Legal Business Name): MICHAEL VERNON MILLS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2009
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 CHARTER BLVD STE 3302
MACON GA
31210-0711
US

IV. Provider business mailing address

900 CIRCLE 75 PKWY SE STE 1700
ATLANTA GA
30339-3087
US

V. Phone/Fax

Practice location:
  • Phone: 478-200-5710
  • Fax: 770-953-6972
Mailing address:
  • Phone: 770-953-6929
  • Fax: 770-953-6972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number48907
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberD0083611
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number99541
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: