| Mills Family Clinic, Pllc | |
|
108 W Randolph Ave Enid OK 73701-4005 | |
| (580) 278-6804 | |
| (888) 498-4576 |
| Full Name | Mills Family Clinic, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 108 W Randolph Ave, Enid, Oklahoma |
| Authorized Official Name and Position | Jon Randall Mills (ADVISOR) |
| Authorized Official Contact | 9183049608 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mills Family Clinic, Pllc 5821 W Orlando Cir Broken Arrow OK 74011-1153 Ph: (918) 304-9608 | Mills Family Clinic, Pllc 108 W Randolph Ave Enid OK 73701-4005 Ph: (580) 278-6804 |
| NPI Number | 1285379909 |
|---|---|
| Provider Enumeration Date | 04/28/2022 |
| Last Update Date | 08/18/2023 |
| Medicare PECOS PAC ID | 3173903440 |
|---|---|
| Medicare Enrollment ID | O20220704000221 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285379909 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jon R Mills |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952627069 PECOS PAC ID: 0648446203 Enrollment ID: I20120103000174 |
| Provider Name | Adrienne Tess Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932694957 PECOS PAC ID: 5597015164 Enrollment ID: I20180830003115 |
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