Healthcare Provider Details

I. General information

NPI: 1477618007
Provider Name (Legal Business Name): STEVE MILLER DPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 S BROADWAY AVE
HOBART OK
73651-1846
US

IV. Provider business mailing address

304 S BROADWAY AVE P.O. BOX 192
HOBART OK
73651-1846
US

V. Phone/Fax

Practice location:
  • Phone: 580-726-2206
  • Fax: 580-726-3511
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8572
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: