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Individual

MR. JON RANDALL MILLS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3815 W. CARRIER RD, ENID, OK 73703
(580) 278-6804
(888) 498-4576
Mailing address
P.O. BOX 1195, BIXBY, OK 74008
(580) 278-6804
(888) 498-4576

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5047
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200400290A
OK
Enumeration date
04/14/2010
Last updated
06/21/2023
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