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Individual

AMANDA JO MILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1102 E 2ND ST, CUSHING, OK 74023-4139
(918) 225-3006
(918) 225-0894
Mailing address
1102 E 2ND ST, CUSHING, OK 74023-4139
(918) 225-3006
(918) 225-0894

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
29120
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200525990B
OK
Enumeration date
04/23/2012
Last updated
01/23/2017
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