Provider Demographics
NPI:1659375194
Name:MILLER, FRANKLIN (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 HOT SPRINGS BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-3481
Mailing Address - Country:US
Mailing Address - Phone:505-425-3596
Mailing Address - Fax:505-425-2789
Practice Address - Street 1:1900 HOT SPRINGS BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-3481
Practice Address - Country:US
Practice Address - Phone:505-425-3596
Practice Address - Fax:505-425-2789
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM75-211207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM35121Medicaid
NM35121Medicaid
NM35121Medicaid