Healthcare Provider Details

I. General information

NPI: 1053316620
Provider Name (Legal Business Name): FRANCIS P. MACMILLAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 05/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PARKWAY
HAVERHILL MA
01830-6278
US

IV. Provider business mailing address

1 PARKWAY
HAVERHILL MA
01830-6278
US

V. Phone/Fax

Practice location:
  • Phone: 978-521-3235
  • Fax: 978-521-3236
Mailing address:
  • Phone: 978-521-3235
  • Fax: 978-521-3236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number80533
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: