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General NPI Number Information
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NPI Number | 1467451435
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Entity Type | Individual
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Provider Name | ROBERT CHARLES MILLS MD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 200 MEDICAL CENTER DR
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City | FORT PAYNE
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State | AL
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Zip | 35968
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Country | US
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Telephone | 256-845-3150
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 680949
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City | FORT PAYNE
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State | AL
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Zip | 35968-1610
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Country | US
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Telephone | 256-997-2189
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Fax | 256-638-7445
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 28672
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 27980
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License Number State | AL
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