Active NPI
Barry Duane McMillon, PA-C
- Physician Assistant
- Tucson, AZ
National Provider Identifier
1457413346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2753
- Practice address
- 39580 S Lago del Oro Pkwy
Tucson, AZ 85739-1091 - Phone
- (520) 624-4000
- NPI assigned
- Dec 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2753 | AZ | Primary |
Addresses
Primary practice location
39580 S Lago del Oro Pkwy
Tucson, AZ 85739-1091
Mailing address
1233 S Joey PL
Tucson, AZ 85713-1158
Phone (520) 240-3694
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2753 | AZ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457413346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1233 S JOEY PL",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857131158",
"telephone_number": "520-240-3694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39580 S LAGO DEL ORO PKWY",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857391091",
"telephone_number": "520-624-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMILLON",
"first_name": "BARRY",
"middle_name": "DUANE",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "2753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.