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General NPI Number Information
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NPI Number | 1902069073
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Entity Type | Individual
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Provider Name | OMIE MILLS MD
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Gender | Female
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 901 SE PLAZA AVE. SUITE #5
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City | BENTONVILLE
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State | AR
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Zip | 72712
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Country | US
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Telephone | 479-273-3376
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Fax | 479-273-3468
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Provider Business Mailing Address
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Address Line | 500 S 52ND ST SUITE #5
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City | ROGERS
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State | AR
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Zip | 72758-8600
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Country | US
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Telephone | 479-273-3376
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Fax | 479-273-3468
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | E7097
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License Number State | AR
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