# MILLENNIUM MEDICAL SERVICES, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MILLENNIUM MEDICAL SERVICES, L.L.C.
- **Other names:** Poteau Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1568897585
- **Legal business name:** MILLENNIUM MEDICAL SERVICES, L.L.C.
- **Authorized official:** DR. WADE L HAMIL PHD (CEO)
- **Authorized official phone:** (405) 627-0276

## Contact information

- **Practice address:** 1212 REYNOLDS AVE, POTEAU, OK 74953-4724
- **Practice address phone:** (888) 573-7792
- **Practice address fax:** (888) 753-8162
- **Mailing address:** 3816 SHADOWRIDGE DR, NORMAN, OK 73072-5308
- **Mailing address phone:** (888) 573-7792
- **Mailing address fax:** (888) 753-8162

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | Yes |
| 2084P0800X | Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/10/2013
- **Last updated:** 04/22/2020