Provider Demographics
NPI:1871240580
Name:MILLER MEDICAL, INC
Entity Type:Organization
Organization Name:MILLER MEDICAL, INC
Other - Org Name:MILLER MEDICAL, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-915-6262
Mailing Address - Street 1:755 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TREMONTON
Mailing Address - State:UT
Mailing Address - Zip Code:84337-2327
Mailing Address - Country:US
Mailing Address - Phone:435-915-6262
Mailing Address - Fax:
Practice Address - Street 1:57 N 775 E
Practice Address - Street 2:
Practice Address - City:TREMONTON
Practice Address - State:UT
Practice Address - Zip Code:84337-4103
Practice Address - Country:US
Practice Address - Phone:435-915-6262
Practice Address - Fax:435-201-8200
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILLER MEDICAL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-03
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty