Provider Demographics
NPI:1720024003
Name:MILLS, C. SCOTT (AUD)
Entity Type:Individual
Prefix:DR
First Name:C.
Middle Name:SCOTT
Last Name:MILLS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3780 CLEMMONS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-7514
Mailing Address - Country:US
Mailing Address - Phone:336-766-2677
Mailing Address - Fax:336-778-2277
Practice Address - Street 1:3780 CLEMMONS RD
Practice Address - Street 2:SUITE A
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-7514
Practice Address - Country:US
Practice Address - Phone:336-766-2677
Practice Address - Fax:336-778-2277
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2116237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC59334OtherBCBS NC INDIVID PROVIDER
NC2520967Medicare ID - Type UnspecifiedIND MEDICARE PROVIDER