Provider Demographics
NPI:1730179300
Name:MILLS, DON EDWARD JR (OD)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:EDWARD
Last Name:MILLS
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:492 WILLIAMSON RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9185
Mailing Address - Country:US
Mailing Address - Phone:704-664-9121
Mailing Address - Fax:704-664-4886
Practice Address - Street 1:492 WILLIAMSON RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9185
Practice Address - Country:US
Practice Address - Phone:704-664-9121
Practice Address - Fax:704-664-4886
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1135152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC410017584OtherRAILROAD MEDICARE
NC09616OtherBLUE CROSS BLUE SHIELD
NC0661770001Medicare NSC
NC246625AMedicare PIN
NCT81632Medicare UPIN