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John
N
McMillin
MD
Contract Details
Occupational Health Center--Pascagoula
Facility name
Provider ID
P000008409
NPI
1649250671
Tax ID
463558386
Effective Date
1/1/2016
Last Updated
3/7/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
89.00
Location Details
Address
5912 Old Mobile Avenue Suite 1
Pascagoula, MS 39581
United States
County
Jackson
Phone
2287624642
(
Phone
)
Billing Details
Address
2050 Michigan Avenue
Mobile, AL 36615
Billing Phone
2514346779
Specialty Type
Occupational Medicine
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Address