Organization
MILLENNIUM MEDICAL SERVICES, L.L.C.
Active
Parent organization
MILLENNIUM MEDICAL SERVICES, L.L.C.
Other names
Hobart Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
MILLENNIUM MEDICAL SERVICES, L.L.C.
Authorized official
DR. WADE L HAMIL PHD (CEO)
(405) 627-0276
Entity
Organization
Contact information
Practice address
221 W 3RD ST, HOBART, OK 73651-3603
(888) 573-7792
(888) 753-8162
Mailing address
3816 SHADOWRIDGE DR STE 101, NORMAN, OK 73072-5308
(405) 573-9905
(888) 753-8162
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200004820E
—
OK
Enumeration date
12/04/2013
Last updated
04/22/2020
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