Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 15653 | OK |
NPI | 1336169952 |
---|---|
Provider Name | Dr. Archibald Sanford Miller III |
First Address | Tulsa, OK 74136-8384 |
Second Address | Tulsa, OK 74136-8384 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 22/12/2011 |