MEDICARE: MRS. LAURA SARFATIS MILES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	18054	OK
2	208D00000X	General Practice Physician	18054	OK

General Provider Information

NPI Number	:	1053388504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURA SARFATIS MILES MD

Provider Business Mailing Address
First Line	:	912 NW 139TH STREET PKWY
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73013-9525
Country	:	US
Telephone Number	:	405-608-4447
Fax Number	:	405-286-1261

Provider Business Practice Location Address
First Line	:	912 NW 139TH STREET PKWY
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73013-9525
Country	:	US
Telephone Number	:	405-608-4447
Fax Number	:	405-286-1261

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	05/03/2015

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