Provider Demographics
NPI:1659470946
Name:MCMILLEN, JAMES IAN (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:IAN
Last Name:MCMILLEN
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 1:5673 PEACHTREE DUNWOODY RD STE 330
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1774
Mailing Address - Country:US
Mailing Address - Phone:404-459-0002
Mailing Address - Fax:404-459-0003
Practice Address - Street 1:5673 PEACHTREE DUNWOODY RD STE 330
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1774
Practice Address - Country:US
Practice Address - Phone:404-459-0002
Practice Address - Fax:404-459-0003
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047984207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00100569OtherMC RAILROAD
GA245866718AMedicaid
H89940Medicare UPIN
P00100569OtherMC RAILROAD
GA245866718AMedicaid