Provider Demographics
NPI:1811177009
Name:MILLER, ROBERT DOUGLAS (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DOUGLAS
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8205 ESTATES PKWY STE F
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43064-8018
Mailing Address - Country:US
Mailing Address - Phone:614-873-7487
Mailing Address - Fax:
Practice Address - Street 1:204 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAIN CITY
Practice Address - State:OH
Practice Address - Zip Code:43064
Practice Address - Country:US
Practice Address - Phone:614-873-7487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2018-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3841111N00000X, 111NN0400X, 111NN1001X, 111NR0400X, 111NT0100X, 111NX0800X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
No111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NT0100XChiropractic ProvidersChiropractorThermography
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2831216Medicaid
OH1295911535OtherENTITY NPI
OH2811158Medicaid