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NPI Code Detail

MEDICARE: TIMOTHY D MILLS DPH

MEDICARE: TIMOTHY D MILLS DPH
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
1183500000XPharmacist11626OK

General Provider Information

NPI Number : 1558374728
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY D MILLS DPH
Provider Business Mailing Address
First Line : PO BOX 637
Second Line :
City : ADA
State : OK
Zip : 74821-0637
Country : US
Telephone Number : 580-332-6639
Fax Number :
Provider Business Practice Location Address
First Line : 1000 ROLLING HILLS LN
Second Line :
City : ADA
State : OK
Zip : 74820-9415
Country : US
Telephone Number : 580-436-3600
Fax Number : 580-436-3958
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2006
Last Update Date : 09/09/2015

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