Healthcare Provider Details

I. General information

NPI: 1902960065
Provider Name (Legal Business Name): MATTHEW B MILLS MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10685 PROFESSIONAL CIR SUITE A
RENO NV
89521-5856
US

IV. Provider business mailing address

10685 PROFESSIONAL CIR SUITE A
RENO NV
89521-5856
US

V. Phone/Fax

Practice location:
  • Phone: 775-322-1000
  • Fax: 775-322-1050
Mailing address:
  • Phone: 775-322-1000
  • Fax: 775-322-1050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2675
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number9064
License Number StateNV

VIII. Authorized Official

Name: MATTHEW BRONSON MILLS
Title or Position: OWNER
Credential: MD
Phone: 775-322-1000