MEDICARE: DR. JAMES L MILLEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	030834	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	205991996001	OTHER	GA	BCBS

General Provider Information

NPI Number	:	1558373043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES L MILLEN MD

Provider Business Mailing Address
First Line	:	1203B GEORGE C WILSON DR
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-4502
Country	:	US
Telephone Number	:	706-447-1118
Fax Number	:	706-826-2775

Provider Business Practice Location Address
First Line	:	1203B GEORGE C WILSON DR
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-4502
Country	:	US
Telephone Number	:	706-447-1118
Fax Number	:	706-826-2775

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	05/20/2024

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