Provider Demographics
NPI:1609836758
Name:MILLWARD, JOHN ALEXANDER (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ALEXANDER
Last Name:MILLWARD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:5830 SUNNINGDALE LN
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-8616
Mailing Address - Country:US
Mailing Address - Phone:910-425-2875
Mailing Address - Fax:
Practice Address - Street 1:WAMC 2817 REILLY RD
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-0001
Practice Address - Country:US
Practice Address - Phone:910-907-6155
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical