Provider Demographics
NPI:1861671059
Name:MILLER, KARLA LISSETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:KARLA
Middle Name:LISSETTE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N 1900 E
Mailing Address - Street 2:4B200 SCHOOL OF MEDICINE
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0006
Mailing Address - Country:US
Mailing Address - Phone:801-581-4333
Mailing Address - Fax:801-581-6069
Practice Address - Street 1:30 N 1900 E
Practice Address - Street 2:4B200 SCHOOL OF MEDICINE
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0006
Practice Address - Country:US
Practice Address - Phone:801-581-4333
Practice Address - Fax:801-581-6069
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5756993-1205207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology