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General NPI Number Information
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NPI Number | 1639626500
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Entity Type | Organization
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Legal Business Name | MCMILLAN INSTITUTE OF REGENERATIVE ORTHOPEDICS, PC
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 12/27/2016
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Provider Practice Location Address
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Address Line | 1069 E HAWKEYE AVE STE C
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City | TURLOCK
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State | CA
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Zip | 95380-2618
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Country | US
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Telephone | 209-272-7442
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Fax | 209-272-7443
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Provider Business Mailing Address
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Address Line | PO BOX 1123
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City | TURLOCK
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State | CA
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Zip | 95381-1123
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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 | PRESIDENT
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Name | DR. ERIC MCMILLAN
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Credential | MD
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Telephone | 209-272-7442
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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 |
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License Number State |
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