Fred L McMillan, MD, PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

05468 Issued in MS

Legal business name

FRED L MCMILLAN, MD, PLLC

Practice address

1421 N State St
Suite 503
Jackson, MS 39202-1658

Phone

(601) 948-6886

Fax

(601) 948-7044

NPI assigned

Dec 5, 2007

Last updated

Apr 10, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Fred L McMillan, MD

Title

Owner

Phone

(601) 948-6886

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1427230168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 N STATE ST",
            "address_2": "SUITE 503",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021658",
            "telephone_number": "601-948-6886",
            "fax_number": "601-948-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 N STATE ST",
            "address_2": "SUITE 503",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021658",
            "telephone_number": "601-948-6886",
            "fax_number": "601-948-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED L MCMILLAN, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "MCMILLAN",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-948-6886",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "05468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015679",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Alexandra Fratesi, MD
• Alethia Frazier
• Coretta Frazier, MBA-HRM
• Eric Frazier, PA-C
• Jimmy Frazier
• Ruth Kellum Fredericks, M.D.
• Freds Pharmacy
• Freds Stores of Tennessee Inc (Freds Pharmacy 2046)
• Freds Stores of Tennessee Inc (Freds Pharmacy 2051)
• Catherine C Freeman, CRNA

• Ophthalmology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Ophthalmology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.