Provider Demographics
NPI:1275905440
Name:MILLIGAN SURGICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:MILLIGAN SURGICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-347-2960
Mailing Address - Street 1:1919 PINNACLE POINTE WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922
Mailing Address - Country:US
Mailing Address - Phone:865-347-2960
Mailing Address - Fax:865-851-8758
Practice Address - Street 1:1919 PINNACLE POINTE WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922
Practice Address - Country:US
Practice Address - Phone:865-347-2960
Practice Address - Fax:865-851-8758
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILLIGAN SURGICAL ASSOCIATES, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1519350Medicaid
TN1519350Medicaid