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General NPI Number Information
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NPI Number | 1295758365
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Entity Type | Individual
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Provider Name | JEFFREY T MACMILLAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 255 W 4TH ST
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City | KIMBALL
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State | NE
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Zip | 69145-1706
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Country | US
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Telephone | 308-235-1951
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 920
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City | TORRINGTON
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State | WY
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Zip | 82240-0920
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Country | US
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Telephone | 913-894-2121
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Fax | 913-894-9592
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 04-25519
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 29753
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License Number State | NE
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