Provider Demographics
NPI:1285824045
Name:MILFORD, KIMBERLY ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANN
Last Name:MILFORD
Suffix:
Gender:F
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:PO BOX 751
Mailing Address - Street 2:
Mailing Address - City:HULBERT
Mailing Address - State:OK
Mailing Address - Zip Code:74441-0751
Mailing Address - Country:US
Mailing Address - Phone:918-772-3390
Mailing Address - Fax:918-772-2244
Practice Address - Street 1:1500 E DOWNING ST STE 102
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-3354
Practice Address - Country:US
Practice Address - Phone:918-207-0773
Practice Address - Fax:918-207-0774
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101244224208000000X
OK30442208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics