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General NPI Number Information
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NPI Number | 1669646113
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Entity Type | Organization
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Legal Business Name | MILO CLINIC
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 1305 E TAFT ST
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City | SAPULPA
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State | OK
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Zip | 74066-6033
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Country | US
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Telephone | 918-224-3069
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Fax | 918-224-3091
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Provider Business Mailing Address
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Address Line | 1305 E TAFT ST
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City | SAPULPA
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State | OK
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Zip | 74066-6033
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Country | US
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Telephone | 918-224-3069
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Fax | 918-224-3091
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | MR. EMIL B MILO
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Credential | MD
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Telephone | 918-224-3069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | OK
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