Provider Demographics
NPI:1265484315
Name:WILLIAM S MILLER, MD, PC
Entity Type:Organization
Organization Name:WILLIAM S MILLER, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-725-6514
Mailing Address - Street 1:201 S PRESTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:RANSON
Mailing Address - State:WV
Mailing Address - Zip Code:25438-1675
Mailing Address - Country:US
Mailing Address - Phone:304-725-6514
Mailing Address - Fax:
Practice Address - Street 1:201 S PRESTON ST STE A
Practice Address - Street 2:
Practice Address - City:RANSON
Practice Address - State:WV
Practice Address - Zip Code:25438-1675
Practice Address - Country:US
Practice Address - Phone:304-725-6514
Practice Address - Fax:304-725-3781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001721157OtherBLUE CROSS/BLUE SHIELD
WV0056320000Medicaid
WV0489491OtherPTAN
WV822511OtherMAMSI/UNITED HEALTHCARE
WV12485OtherWV STATE LICENCE NUMBER
WV410113203OtherRAILROAD MEDICARE
WV4503451OtherAETNA
WV4503451OtherAETNA
WV12485OtherWV STATE LICENCE NUMBER
WVA72116Medicare UPIN