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General NPI Number Information
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NPI Number | 1518071802
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Entity Type | Individual
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Provider Name | HORATIO MILLIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 977 BAYWOOD DR
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City | LAKE CHARLES
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State | LA
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Zip | 70611
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Country | US
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Telephone | 318-884-8898
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Fax |
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Provider Business Mailing Address
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Address Line | 977 BAYWOOD DR
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City | LAKE CHARLES
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State | LA
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Zip | 70611-6817
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Country | US
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Telephone | 318-884-8898
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 14323R
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License Number State | LA
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