Provider Demographics
NPI:1841350816
Name:RICHARD J MILLIGAN MD PC
Entity type:Organization
Organization Name:RICHARD J MILLIGAN MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-205-2388
Mailing Address - Street 1:PO BOX 767
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-0767
Mailing Address - Country:US
Mailing Address - Phone:269-205-2388
Mailing Address - Fax:269-205-2389
Practice Address - Street 1:5671 N SKEEL AVE
Practice Address - Street 2:
Practice Address - City:OSCODA
Practice Address - State:MI
Practice Address - Zip Code:48750-1535
Practice Address - Country:US
Practice Address - Phone:269-205-2388
Practice Address - Fax:269-205-2389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2014-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301037691208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1355841Medicaid
MI0045594Medicare ID - Type Unspecified
MI1355841Medicaid