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Individual

MICAH DOUGLASS NIX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
613 S SHAWNEE ST, SKIATOOK, OK 74070-1886
(918) 706-4575
Mailing address
613 S SHAWNEE ST, SKIATOOK, OK 74070-1886
(918) 706-4575

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5107
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200397460A
OK
Enumeration date
08/26/2010
Last updated
10/03/2024
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