Provider Demographics
NPI:1013288919
Name:MCNEILL, KEVIN MILLS (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:MILLS
Last Name:MCNEILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1710 WHITEHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-8523
Mailing Address - Country:US
Mailing Address - Phone:601-813-3527
Mailing Address - Fax:706-529-5740
Practice Address - Street 1:129 CALUMET DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-9298
Practice Address - Country:US
Practice Address - Phone:601-605-8956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-24
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD 208522083P0901X
GA0511632083P0901X
MS073352083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine