Millette, Theodore Michael

Millette, Theodore Michael is an individual health care provider with primary practice located at 4105 Hospital St Ste 103, Pascagoula MS 39581-5312. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Millette, Theodore Michael can be contacted via phone (228) 762-8712.

Contact Information

Primary practice address
4105 Hospital St Ste 103 Pascagoula MS 39581-5312
Phone: (228) 762-8712
Fax: (228) 762-2261
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 09156 Mississippi

Profile Details

NPI number 1174591036
LBN Legal business name Millette, Theodore Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174591036 NPPES
Mississippi MEDICAID 00016711
Mississippi Other 0005309051

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