Provider Demographics
NPI:1447310701
Name:MILLS, MARK ANSON (DIPL AC)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:ANSON
Last Name:MILLS
Suffix:
Gender:M
Credentials:DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 W LINDSEY ST
Mailing Address - Street 2:SUITE C-160
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-4159
Mailing Address - Country:US
Mailing Address - Phone:405-321-5546
Mailing Address - Fax:
Practice Address - Street 1:1818 W LINDSEY ST
Practice Address - Street 2:SUITE C-160
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-4159
Practice Address - Country:US
Practice Address - Phone:405-321-5546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA625171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist