Provider Demographics
NPI:1356444350
Name:MILLER, WILLIAM CHRIS (DPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CHRIS
Last Name:MILLER
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4119 KOERNER RD
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:OK
Mailing Address - Zip Code:73078-9684
Mailing Address - Country:US
Mailing Address - Phone:405-373-3048
Mailing Address - Fax:
Practice Address - Street 1:12320 N MUSTANG RD
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-8166
Practice Address - Country:US
Practice Address - Phone:405-373-1717
Practice Address - Fax:405-373-3954
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9881183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK9881OtherSTATE BOARD OF PHEY