Basic Information
| Provider Information | |||||||||
| NPI: | 1174745830 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RODNEY J. MILES, M.D., INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 520 S TELEPHONE RD | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | MOORE | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731605423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057944664 | ||||||||
| FaxNumber: | 4057942853 | ||||||||
| Practice Location | |||||||||
| Address1: | 520 S TELEPHONE RD | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | MOORE | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731605423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057944664 | ||||||||
| FaxNumber: | 4057942853 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MILES | ||||||||
| AuthorizedOfficialFirstName: | RODNEY | ||||||||
| AuthorizedOfficialMiddleName: | JAMES | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4057944664 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | 13897 | OK | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.