Provider Demographics
NPI:1417122706
Name:MILLER, KLAS DANIEL (DO)
Entity Type:Individual
Prefix:
First Name:KLAS
Middle Name:DANIEL
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 1:1230 E 6TH AVE STE 2D
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-3145
Mailing Address - Country:US
Mailing Address - Phone:620-222-6250
Mailing Address - Fax:620-222-6251
Practice Address - Street 1:1230 E. SIXTH AVE
Practice Address - Street 2:SUITE 2D
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156
Practice Address - Country:US
Practice Address - Phone:620-222-6250
Practice Address - Fax:620-222-6251
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-33064207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology