Provider Demographics
NPI:1699833244
Name:MILLSPAUGH, VERNON B II (DC)
Entity Type:Individual
Prefix:DR
First Name:VERNON
Middle Name:B
Last Name:MILLSPAUGH
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:325 PIEDMONT RD N
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:OK
Mailing Address - Zip Code:73078-8185
Mailing Address - Country:US
Mailing Address - Phone:405-478-1507
Mailing Address - Fax:405-359-1877
Practice Address - Street 1:325 PIEDMONT RD N
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:OK
Practice Address - Zip Code:73078-8185
Practice Address - Country:US
Practice Address - Phone:405-478-1507
Practice Address - Fax:405-359-1877
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3651111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK800522194Medicare ID - Type UnspecifiedPROVIDER NUMBER