Provider Demographics
NPI:1770709735
Name:MILLER EYE CARE, INC.
Entity type:Organization
Organization Name:MILLER EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-255-2501
Mailing Address - Street 1:1311 JACKIE RD
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1566
Mailing Address - Country:US
Mailing Address - Phone:580-255-2501
Mailing Address - Fax:580-255-2117
Practice Address - Street 1:1311 JACKIE RD
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1566
Practice Address - Country:US
Practice Address - Phone:580-255-2501
Practice Address - Fax:580-255-2117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11524207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100141280AMedicaid
D35045Medicare UPIN
450785955Medicare ID - Type Unspecified
OK100141280AMedicaid