Provider Demographics
NPI:1013798339
Name:MILLS, IRIS A
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:A
Last Name:MILLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2812 E 97TH CT APT 208
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-7358
Mailing Address - Country:US
Mailing Address - Phone:918-798-3000
Mailing Address - Fax:
Practice Address - Street 1:2812 E 97TH CT APT 208
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-7358
Practice Address - Country:US
Practice Address - Phone:918-798-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty