| Organization Name: | ROBERT D MILLICAN OD PC |
| NPI Number: | 1730341132 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT D MILLICAN (OPTOMETRIST) |
| Mailing Address: | 1626 Frederica Rd Ste 101 St Simons Island |
| State: | GA US |
| Postal Code: | 315222525 |
| Phone Number: | 9126345711 |
| Fax Number: | 9126345713 |
| NPI Enumeration Date: | 06/26/2008 |
| NPI Last Update Date: | 09/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | OPT0245 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |