Provider Demographics
NPI:1215728845
Name:MILLER, CARRICK
Entity type:Individual
Prefix:
First Name:CARRICK
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8739 PRIVATE ROAD 343
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44654-8494
Mailing Address - Country:US
Mailing Address - Phone:330-600-9953
Mailing Address - Fax:
Practice Address - Street 1:8739 PRIVATE ROAD 343
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:OH
Practice Address - Zip Code:44654-8494
Practice Address - Country:US
Practice Address - Phone:330-600-9953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant