Provider Demographics
NPI:1407822737
Name:MACMILLAN, RICHARD HUNT III (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HUNT
Last Name:MACMILLAN
Suffix:III
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:PO BOX 480
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45802-0480
Mailing Address - Country:US
Mailing Address - Phone:866-223-6316
Mailing Address - Fax:419-223-2726
Practice Address - Street 1:500 MARTHA JEFFERSON DR.
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911
Practice Address - Country:US
Practice Address - Phone:434-654-7190
Practice Address - Fax:434-654-7944
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101037032207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006600255Medicaid
VA080666OtherBCBS #
VA080666OtherBCBS #
VA006600255Medicaid
D92631Medicare UPIN