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General NPI Number Information
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NPI Number | 1053400598
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Entity Type | Individual
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Provider Name | KEITH R MILLS MD
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 20 KINGFISHER ROAD
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City | NEW HARBOR
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State | ME
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Zip | 04554
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Country | US
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Telephone | 307-262-5949
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Fax | 844-320-9753
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Provider Business Mailing Address
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Address Line | 20 KINGFISHER ROAD
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City | NEW HARBOR
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State | ME
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Zip | 04554
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Country | US
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Telephone | 307-262-5949
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Fax | 844-320-9753
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | CP206749
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 6639A
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License Number State | WY
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