Provider Demographics
NPI:1891426466
Name:MILLER, MORGAN TANNER (OD)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:TANNER
Last Name:MILLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:450 S CAMINO DEL RIO STE 101
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-6856
Mailing Address - Country:US
Mailing Address - Phone:970-759-5404
Mailing Address - Fax:970-247-5823
Practice Address - Street 1:450 S CAMINO DEL RIO STE 101
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-6856
Practice Address - Country:US
Practice Address - Phone:970-759-5404
Practice Address - Fax:970-247-5823
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT0003807152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist