Bradley McMillen, MD
Family Medicine in Jackson, TN. Individual provider (NPI-1).
NPI number1962030163
StatusActive
Last updated in NPPESJun 28, 2023
Details
- NPI
- 1962030163
- Entity type
- Individual (NPI-1)
- Name
- Bradley McMillen
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 1, 2020
- Certification date
- Jun 28, 2023
- Last updated
- Jun 28, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 64537 | TN | Yes |
| 207P00000X | Emergency Medicine | 64537 | TN |
Practice location
620 Skyline DrJackson, TN 38301-3923
Phone 731-541-5000
Mailing address
60 Isaiah DrJackson, TN 38305-2413
Phone 352-512-4717
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