Provider Demographics
NPI:1255568119
Name:MILLER, LONNY D (MD)
Entity type:Individual
Prefix:DR
First Name:LONNY
Middle Name:D
Last Name:MILLER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 140TH ST
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-8026
Mailing Address - Country:US
Mailing Address - Phone:641-745-9428
Mailing Address - Fax:
Practice Address - Street 1:909 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:IA
Practice Address - Zip Code:50674-1203
Practice Address - Country:US
Practice Address - Phone:563-578-5375
Practice Address - Fax:563-578-2163
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE34157207Q00000X
TXT0285207Q00000X
MO2022037575207Q00000X
FLME160380207Q00000X
UT13246298-1205207Q00000X
AZ68928207Q00000X
GA94920207Q00000X
NMMD2023-0387207Q00000X
VA0101279887207Q00000X
ND20440207Q00000X
MN75637207Q00000X
COCDR.0003372207Q00000X
WI3676-320207Q00000X
KS04-48614207Q00000X
IAMD-40151207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine