Provider Demographics
NPI:1285632422
Name:MCMILLAN, EUAN MURRAY (MD)
Entity Type:Individual
Prefix:DR
First Name:EUAN
Middle Name:MURRAY
Last Name:MCMILLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 SAINT GREGORY DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8332
Mailing Address - Country:US
Mailing Address - Phone:405-752-1800
Mailing Address - Fax:
Practice Address - Street 1:4320 SAINT GREGORY DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8332
Practice Address - Country:US
Practice Address - Phone:405-752-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12875207N00000X, 207NI0002X, 207NP0225X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
070001248OtherRAILROAD MEDICARE
OK37D0471394OtherC.L.I.A.
OK731248896-001OtherBLUE CROSS BLUE SHIELD
OKC95242Medicare UPIN