Provider Demographics
NPI:1689421463
Name:MILLIGAN, IAN PATRICK (IDHS)
Entity type:Individual
Prefix:
First Name:IAN
Middle Name:PATRICK
Last Name:MILLIGAN
Suffix:
Gender:M
Credentials:IDHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USCGC HICKORY (WLB-212) US NAVAL ACTIVITIES
Mailing Address - Street 2:VICTOR WHARF, PIER 3
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96915
Mailing Address - Country:US
Mailing Address - Phone:671-685-5231
Mailing Address - Fax:671-355-4928
Practice Address - Street 1:USCGC HICKORY (WLB-212) US NAVAL ACTIVITIES
Practice Address - Street 2:VICTOR WHARF, PIER 3
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96915
Practice Address - Country:US
Practice Address - Phone:671-685-5231
Practice Address - Fax:671-355-4928
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman