Provider Demographics
NPI:1013207133
Name:MILLICAN, ERIC AUSTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:AUSTIN
Last Name:MILLICAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2146 BELCOURT AVE
Mailing Address - Street 2:VMG BUSINESS OFFICE
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-3504
Mailing Address - Country:US
Mailing Address - Phone:615-322-0845
Mailing Address - Fax:615-343-3947
Practice Address - Street 1:719 THOMPSON LN
Practice Address - Street 2:SUITE 26300
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204
Practice Address - Country:US
Practice Address - Phone:615-322-0845
Practice Address - Fax:615-343-3947
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2021-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT9376178-1205207ND0101X, 207N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program