Healthcare Provider Details

I. General information

NPI: 1649912056
Provider Name (Legal Business Name): CHRISTOPHER SCOTT MCMILLAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 DOCTORS DR
GREENVILLE SC
29605-5608
US

IV. Provider business mailing address

113 DOCTORS DR
GREENVILLE SC
29605-5608
US

V. Phone/Fax

Practice location:
  • Phone: 864-269-3333
  • Fax:
Mailing address:
  • Phone: 864-269-3333
  • Fax: 864-626-0757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number97125
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: