Provider Demographics
NPI:1346329190
Name:MILLER, LINWOOD (DO)
Entity Type:Individual
Prefix:DR
First Name:LINWOOD
Middle Name:
Last Name:MILLER
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 1:501 S WHITE ST
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:MT PLEASANT
Mailing Address - State:IA
Mailing Address - Zip Code:52641-2600
Mailing Address - Country:US
Mailing Address - Phone:319-385-6700
Mailing Address - Fax:319-385-6703
Practice Address - Street 1:501 S WHITE ST
Practice Address - Street 2:SUITE ONE
Practice Address - City:MT PLEASANT
Practice Address - State:IA
Practice Address - Zip Code:52641-2600
Practice Address - Country:US
Practice Address - Phone:319-385-6700
Practice Address - Fax:319-385-6703
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01763207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0182170Medicaid
IA0182170Medicaid
IA01001Medicare PIN