Provider Demographics
NPI:1326062290
Name:MILES, WILLIAM D (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:MILES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2466 TENNYSON DR
Mailing Address - Street 2:
Mailing Address - City:BELLBROOK
Mailing Address - State:OH
Mailing Address - Zip Code:45305-1744
Mailing Address - Country:US
Mailing Address - Phone:937-848-9177
Mailing Address - Fax:
Practice Address - Street 1:935 STATE ROUTE 28
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1911
Practice Address - Country:US
Practice Address - Phone:513-831-5955
Practice Address - Fax:513-831-5985
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-4296207P00000X
UT1614711204207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHMI0745733Medicare ID - Type UnspecifiedSPRINGDLE MEDICARE #
OHE83036Medicare UPIN
OHMI0745736Medicare ID - Type UnspecifiedKETTERING MEDICARE #
OHMI0745734Medicare ID - Type UnspecifiedMILFORD MEDICARE #
OHMI0745735Medicare ID - Type UnspecifiedMIDDLETOWN MEDICARE #
OHMI0745738Medicare ID - Type UnspecifiedCOLERAIN MEDICARE #
OHMI045737Medicare ID - Type UnspecifiedDAYTON MEDICARE #