Provider Demographics
NPI:1164551719
Name:MCMILLAN, DAVID WILLIAMS (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAMS
Last Name:MCMILLAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 28TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1411
Mailing Address - Country:US
Mailing Address - Phone:615-327-2183
Mailing Address - Fax:615-320-8751
Practice Address - Street 1:115 28TH AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1411
Practice Address - Country:US
Practice Address - Phone:615-327-2183
Practice Address - Fax:615-320-8751
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0523103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2008725OtherBCBS TN PROVIDER NUMBER
TN3681408Medicare ID - Type UnspecifiedPROVIDER NUMBER