Provider Demographics
NPI:1104860162
Name:MILES, PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:RUNGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-301-9140
Mailing Address - Fax:859-212-5124
Practice Address - Street 1:7388 TURFWAY RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1381
Practice Address - Country:US
Practice Address - Phone:859-301-9140
Practice Address - Fax:859-212-5124
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26274207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2112985Medicaid
KYP00904292OtherRAILROAD MEDICARE
KYP00839866OtherRAILROAD MEDICARE
KY080092526OtherRAILROAD MEDICARE
KY64262744Medicaid
KY0387503Medicare PIN
KY080092526OtherRAILROAD MEDICARE
KYP00904292OtherRAILROAD MEDICARE
KY008580086Medicare PIN
KYP00022167Medicare PIN