Healthcare Provider Details

I. General information

NPI: 1063605863
Provider Name (Legal Business Name): MILLER HEALTH AND WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 E SKELLY DR STE 300
TULSA OK
74105-6220
US

IV. Provider business mailing address

2865 E SKELLY DR STE 300
TULSA OK
74105-6220
US

V. Phone/Fax

Practice location:
  • Phone: 918-742-1996
  • Fax: 918-742-5995
Mailing address:
  • Phone: 918-742-1996
  • Fax: 918-742-5995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE09660
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RUTH A MILLER
Title or Position: MEDICAL DOCTOR
Credential: D.O.
Phone: 918-742-1996