Organization
MILLENNIUM MEDICAL SERVICES, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WADE L HAMIL PHD (CEO)
(888) 573-7792
Entity
Organization
Contact information
Practice address
448 36TH AVE NW STE 101, NORMAN, OK 73072-4743
(888) 573-7792
(888) 753-8162
Mailing address
508 MAN O WAR CT, EDMOND, OK 73025-9512
(405) 623-0509
(405) 844-0729
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
103G00000X
Clinical Neuropsychologist
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200004820A
—
OK
01
—
DA0514
MEDICARE - RAILROAD GROUP
OK
Enumeration date
05/25/2006
Last updated
02/22/2022
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