Provider Demographics
NPI:1174650782
Name:MILLS, MYRON (MD)
Entity Type:Individual
Prefix:DR
First Name:MYRON
Middle Name:
Last Name:MILLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 S QUADRUM DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73108-1101
Mailing Address - Country:US
Mailing Address - Phone:405-416-4246
Mailing Address - Fax:405-949-9352
Practice Address - Street 1:238 S QUADRUM DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73108-1101
Practice Address - Country:US
Practice Address - Phone:405-416-4246
Practice Address - Fax:405-949-9352
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK254472083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine