Provider Demographics
NPI:1649249525
Name:MILNER, TRUDY J (DO)
Entity type:Individual
Prefix:
First Name:TRUDY
Middle Name:J
Last Name:MILNER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1919 S WHEELING AVE
Mailing Address - Street 2:LL 100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5638
Mailing Address - Country:US
Mailing Address - Phone:918-748-7890
Mailing Address - Fax:918-293-3137
Practice Address - Street 1:715 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:PAWHUSKA
Practice Address - State:OK
Practice Address - Zip Code:74056-3201
Practice Address - Country:US
Practice Address - Phone:918-287-9300
Practice Address - Fax:918-287-6138
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-10-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK2801207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100135440AMedicaid
OKE69991Medicare UPIN