Healthcare Provider Details

I. General information

NPI: 1477701969
Provider Name (Legal Business Name): MILLS MEDICAL PRACTICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3733 PARK EAST DR STE 220
BEACHWOOD OH
44122-4337
US

IV. Provider business mailing address

805 N WHITTINGTON PKWY STE 200
LOUISVILLE KY
40222-7102
US

V. Phone/Fax

Practice location:
  • Phone: 800-807-6555
  • Fax: 855-316-2999
Mailing address:
  • Phone: 800-807-6555
  • Fax: 855-316-2999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number35083334
License Number StateOH

VIII. Authorized Official

Name: ALLISON L. BROWN
Title or Position: SECRETARY
Credential:
Phone: 502-394-2100