Healthcare Provider Details

I. General information

NPI: 1619914850
Provider Name (Legal Business Name): DOUGLAS P MACMILLAN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 BILTMORE AVE
ASHEVILLE NC
28801-4601
US

IV. Provider business mailing address

PO BOX 654481
DALLAS TX
75265-4481
US

V. Phone/Fax

Practice location:
  • Phone: 828-213-3524
  • Fax: 828-213-3525
Mailing address:
  • Phone: 866-860-8755
  • Fax: 302-467-1822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number200600321
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number2006-00321
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: