Provider Demographics
NPI:1568107209
Name:MILLION, MICHAEL ALEX (OD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALEX
Last Name:MILLION
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 S 14TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-7229
Mailing Address - Country:US
Mailing Address - Phone:918-916-6453
Mailing Address - Fax:
Practice Address - Street 1:1400 E WADE WATTS AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5652
Practice Address - Country:US
Practice Address - Phone:918-429-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3183152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist