| Dr. Peteryne D. Miller, Md | |
|
4870 S Lewis Ave Ste 205 Tulsa OK 74105-5153 | |
| (918) 863-2910 | |
| Not Available |
| Full Name | Dr. Peteryne D. Miller, Md |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4870 S Lewis Ave Ste 205, Tulsa, Oklahoma |
| Authorized Official Name and Position | Jennifer Owens (OFFICE MAANGER) |
| Authorized Official Contact | 9188632910 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Peteryne D. Miller, Md 4870 S Lewis Ave Ste 205 Tulsa OK 74105-5153 Ph: () - | Dr. Peteryne D. Miller, Md 4870 S Lewis Ave Ste 205 Tulsa OK 74105-5153 Ph: (918) 863-2910 |
| NPI Number | 1356828305 |
|---|---|
| Provider Enumeration Date | 07/23/2018 |
| Last Update Date | 07/23/2018 |
| Medicare PECOS PAC ID | 9537492616 |
|---|---|
| Medicare Enrollment ID | O20190604002185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356828305 | NPI | - | NPPES |
| 200085110B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Peteryne D Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720026362 PECOS PAC ID: 9537172556 Enrollment ID: I20060721000058 |
| Provider Name | Janet L Trogdon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487816104 PECOS PAC ID: 4587883624 Enrollment ID: I20140922002586 |
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