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ROBERT D MILLICAN OD PC NPI 1730341132


NPI Information

NPI: 1730341132
Provider Name: ROBERT D MILLICAN OD PC
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
1626 FREDERICA RD STE 101
ST SIMONS ISLAND, GA
ZIP 31522
Phone: (912) 634-5711
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ROBERT D MILLICAN OD PC is an eyewear supplier in St Simons Island, GA. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. ROBERT D MILLICAN OD PC NPI is 1730341132. The provider is registered as an organization entity type.

The provider's business location address is:

1626 FREDERICA RD STE 101
ST SIMONS ISLAND, GA
ZIP 31522-525
Phone: (912) 634-5711
Fax: (912) 634-5713

The provider's authorized official is Robert D Millican .
The authorized official title is Optometrist and has the following contact phone number (912) 554-2007.

The enumeration date for this NPI number is 6/26/2008 and was last updated on 9/25/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332H00000XEyewear SupplierOPT0245GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11278400001MEDICARE NSCGEORGIA
2U34513MEDICARE UPINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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