Provider Demographics
NPI:1912240516
Name:MILLS, JAMES TYLER JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:TYLER
Last Name:MILLS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1215 LEE ST
Mailing Address - Street 2:BOX 800719
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-0816
Mailing Address - Country:US
Mailing Address - Phone:434-924-2150
Mailing Address - Fax:434-924-2150
Practice Address - Street 1:1084 VINEHAVEN DR NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2438
Practice Address - Country:US
Practice Address - Phone:704-786-5131
Practice Address - Fax:704-784-4129
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2021-05-27
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Provider Licenses
StateLicense IDTaxonomies
NC2019-01578208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2019-01578OtherNC MEDICAL BOARD