Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Bose S. Mikkilineni, MDFACS

Individual provider Surgery Physician · NPI 1407840549

Dr. Bose S. Mikkilineni, MDFACS is a Surgery Physician in Beckley, West Virginia. Practices as a sole proprietor. Licensed in West Virginia.

Licensed in
WV
In the registry since
2005

Practice location Address checks out

419 Carriage Dr
Beckley, WV 25801-2805
Phone: (304) 253-8416
Fax: (866) 461-4726
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 12282 (WV)

Record details

NPI number1407840549
Entity typeIndividual (Type 1)
GenderMale
Credentials MDFACS
Sole proprietorYes
NPI enumeratedSeptember 5, 2005
Last updated in NPPESJune 4, 2013

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