Individual
MR. DAVID RAY MCMILLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.PH.
Contact information
Practice address
312 W 12TH ST, ADA, OK 74820-6406
(580) 332-8888
(580) 332-7965
Mailing address
1513 AUGUSTA DR, ADA, OK 74820-8576
(580) 332-0983
(580) 332-7965
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11769
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11769
PHARMACIST LICENSE
OK
Enumeration date
08/11/2006
Last updated
07/08/2007
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