Provider Demographics
NPI:1326484700
Name:MILLION, KYLE LOGAN
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:LOGAN
Last Name:MILLION
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4845 S SHERIDAN RD STE 510
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-5719
Mailing Address - Country:US
Mailing Address - Phone:918-384-0002
Mailing Address - Fax:918-384-0004
Practice Address - Street 1:4845 S SHERIDAN RD STE 510
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-5719
Practice Address - Country:US
Practice Address - Phone:918-384-0002
Practice Address - Fax:918-384-0004
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist