Provider Demographics
NPI:1245325000
Name:ROBERT C MILLS JR OD PA
Entity type:Organization
Organization Name:ROBERT C MILLS JR OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:252-792-2250
Mailing Address - Street 1:316 S MCCASKEY RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-2150
Mailing Address - Country:US
Mailing Address - Phone:252-792-2250
Mailing Address - Fax:252-792-6293
Practice Address - Street 1:316 S MCCASKEY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2150
Practice Address - Country:US
Practice Address - Phone:252-792-2250
Practice Address - Fax:252-792-6293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2018-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC1337152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909654Medicaid
NC09654OtherNC BSBC INDIVIDUAL
NC2415248OtherUHC INDIVIDUAL
NC0124QOtherNC BCBS GROUP
NC093N6OtherNC BSBS INDIVIDUAL
NC1235178989OtherMILLS INDIVIDUAL NPI
NC1861492019OtherSTERLING INDIVIDUAL NPI
NC5950097Medicaid
NC89093N6Medicaid
NC0346981OtherCIGNA INDIVIDUAL
NC8909654Medicaid
NC=========OtherTAX ID
NC1861492019OtherSTERLING INDIVIDUAL NPI
NC09654OtherNC BSBC INDIVIDUAL
NCT86941Medicare UPIN
NC1146990001Medicare NSC