Provider Demographics
NPI:1629331749
Name:MILLER, KIMBERLY W (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:W
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KIMBERLY
Other - Middle Name:ELEANA
Other - Last Name:WESTHOVEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:701 WILL HALSEY WAY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758
Mailing Address - Country:US
Mailing Address - Phone:256-461-7440
Mailing Address - Fax:256-461-7168
Practice Address - Street 1:701 WILL HALSEY WAY
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758
Practice Address - Country:US
Practice Address - Phone:256-461-7440
Practice Address - Fax:256-461-7168
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL34037208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics