Provider Demographics
NPI:1649250671
Name:MCMILLIN, JOHN NEAL (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:NEAL
Last Name:MCMILLIN
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 1:3280 DAUPHIN STREET
Mailing Address - Street 2:BLDG A 101
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-3060
Mailing Address - Country:US
Mailing Address - Phone:251-450-3700
Mailing Address - Fax:251-545-3010
Practice Address - Street 1:2050 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36615
Practice Address - Country:US
Practice Address - Phone:251-434-6791
Practice Address - Fax:888-334-3354
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4N11207X00000X
ALMD11298207XS0117X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202889002Medicaid
E12522Medicare UPIN
MO004011220Medicare ID - Type Unspecified