Individual
TYLER MCMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4444 E 41ST ST, TULSA, OK 74135-2527
(785) 760-4130
Mailing address
1414 E 39TH ST APT 231, TULSA, OK 74105-3415
(785) 760-4130
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38378
OK
390200000X
Student in an Organized Health Care Education/Training Program
38378
OK
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
10/05/2012
Last updated
09/18/2024
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