Provider Demographics
NPI:1417920158
Name:MILLER, JOHN T (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:MILLER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:9411 N OAK TRFY
Mailing Address - Street 2:SUITE LL1
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2262
Mailing Address - Country:US
Mailing Address - Phone:816-436-7072
Mailing Address - Fax:816-436-2743
Practice Address - Street 1:2790 CLAY EDWARDS DR
Practice Address - Street 2:SUITE 520
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3276
Practice Address - Country:US
Practice Address - Phone:816-221-6750
Practice Address - Fax:816-221-7280
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2007-10-22
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Provider Licenses
StateLicense IDTaxonomies
MOR4F76207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
12565062OtherBCBS OF KC INDIVIDUAL #
P00117065OtherRAILROAD MEDICARE
C50864Medicare UPIN
P00117065OtherRAILROAD MEDICARE