Provider Demographics
NPI:1235243098
Name:L MILLS MD LLC
Entity Type:Organization
Organization Name:L MILLS MD LLC
Other - Org Name:EXCEPTIONAL HEALTHCARE LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-926-0404
Mailing Address - Street 1:70 JUNGERMANN CIR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1622
Mailing Address - Country:US
Mailing Address - Phone:636-926-0404
Mailing Address - Fax:636-939-3218
Practice Address - Street 1:70 JUNGERMANN CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1622
Practice Address - Country:US
Practice Address - Phone:636-926-0404
Practice Address - Fax:636-939-3218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO107929207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOG10358Medicare UPIN