Provider Demographics
NPI:1841230349
Name:MILLS, GERALD PARTICK (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:PARTICK
Last Name:MILLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 NW 56TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4479
Mailing Address - Country:US
Mailing Address - Phone:405-945-5200
Mailing Address - Fax:405-945-5212
Practice Address - Street 1:3330 NW 56TH ST
Practice Address - Street 2:SUITE 500
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4479
Practice Address - Country:US
Practice Address - Phone:405-945-5200
Practice Address - Fax:405-945-5212
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19326207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine