Provider Demographics
NPI:1932161130
Name:STEVEN P MILLER OD PA
Entity Type:Organization
Organization Name:STEVEN P MILLER OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:620-543-2400
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:121 OLD MILL LANE
Mailing Address - City:BUHLER
Mailing Address - State:KS
Mailing Address - Zip Code:67522-0043
Mailing Address - Country:US
Mailing Address - Phone:620-543-2400
Mailing Address - Fax:
Practice Address - Street 1:121 OLD MILL LANE
Practice Address - Street 2:
Practice Address - City:BUHLER
Practice Address - State:KS
Practice Address - Zip Code:67522
Practice Address - Country:US
Practice Address - Phone:620-543-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1720152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS065124OtherBLUE CROSS BLUE SHIELD
KS=========67522 S002OtherTRICARE
KS=========67522 S002OtherTRICARE
KS5552780001Medicare NSC
KS065124OtherBLUE CROSS BLUE SHIELD