Provider Demographics
NPI:1073520466
Name:MCMILLION, VIRGIL WAID (DO)
Entity Type:Individual
Prefix:
First Name:VIRGIL
Middle Name:WAID
Last Name:MCMILLION
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HEALTHCARE DR
Mailing Address - Street 2:
Mailing Address - City:PHILIPPI
Mailing Address - State:WV
Mailing Address - Zip Code:26416-9405
Mailing Address - Country:US
Mailing Address - Phone:304-457-1760
Mailing Address - Fax:
Practice Address - Street 1:1 HEALTHCARE DR
Practice Address - Street 2:
Practice Address - City:PHILIPPI
Practice Address - State:WV
Practice Address - Zip Code:26416-9405
Practice Address - Country:US
Practice Address - Phone:304-457-1760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2059207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV452899OtherCARELINK
WV7062865OtherAETNA
WV247232OtherANTHEM BC/BS-UNION
WV001876173OtherBC/BS
WV247233OtherANTHEM BC/BS-PETERSTOWN
WV3810005927Medicaid
WV452899OtherCARELINK
WV511887Medicare Oscar/Certification
WVMC2026241Medicare PIN
WVI32701Medicare UPIN
WV511837Medicare Oscar/Certification