Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 12875 | OK |
N | 207ND0900X | Dermatopathologist | 12875 | OK |
N | 207NP0225X | Pediatric Dermatologist | 12875 | OK |
NPI | 1285632422 |
---|---|
Provider Name | Dr. Euan Murray Mcmillan |
First Address | Oklahoma City, OK 73120-8332 |
Second Address | Oklahoma City, OK 73120-8332 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 05/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
070001248 | RAILROAD MEDICARE (01) | |
37D0471394 | C.L.I.A. (01) | OK |
731248896-001 | BLUE CROSS BLUE SHIELD (01) | OK |
C95242 | (02) | OK |