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General NPI Number Information
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NPI Number | 1245164649
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Entity Type | Individual
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Provider Name | JAIR EMILIO MILLAN
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Gender | Male
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 4921 JONESBORO RD STE E
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City | FOREST PARK
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State | GA
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Zip | 30297-4301
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Country | US
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Telephone | 404-361-0303
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Fax | 404-361-0353
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Provider Business Mailing Address
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Address Line | 6315 BELLMOORE PARK LN
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City | JOHNS CREEK
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State | GA
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Zip | 30097-2567
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Country | US
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Telephone |
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP287462
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License Number State | GA
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