Healthcare Provider Details

I. General information

NPI: 1578782918
Provider Name (Legal Business Name): MILL CREEK CENTER P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2971 HURRICANE RD
ROCKY FACE GA
30740-8716
US

IV. Provider business mailing address

2971 HURRICANE ROAD
ROCKY FACE GA
30740-8716
US

V. Phone/Fax

Practice location:
  • Phone: 706-673-7889
  • Fax: 706-673-3628
Mailing address:
  • Phone: 706-673-7889
  • Fax: 706-673-3628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RODDY PAUL INGRAHAM
Title or Position: PRESIDENT
Credential: M.D.
Phone: 706-673-7889