| Doctor Name: | DR. RYAN LARRY MCMILLEN |
| NPI Number: | 1255592135 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M |
| License Number: | 558 |
| Business Practice Address: | 1200 Brooks Ln Suite 240 Jefferson Hills, PA - 150253747 |
| Business Phone Number: | 4124691660 |
| Business Fax Number: | 4124698972 |
| Mailing Address: | 1200 Brooks Ln, Suite 240 JEFFERSON HILLS |
| State: | PA |
| Postal Code: | 150253747 |
| Phone Number: | 4124691660 |
| Fax Number: | 4124698972 |
| NPI Enumeration Date: | 06/23/2008 |
| NPI Last Update Date: | 08/10/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 558 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |