Provider Demographics
NPI:1952441446
Name:MILLER, DOUGLAS C (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:C
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2845 W ELK AVE BLDG 100
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1980
Mailing Address - Country:US
Mailing Address - Phone:580-255-9797
Mailing Address - Fax:
Practice Address - Street 1:2845 W ELK AVE BLDG 100
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1980
Practice Address - Country:US
Practice Address - Phone:580-255-9797
Practice Address - Fax:580-255-9826
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK22997208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery