Provider Demographics
NPI:1932227139
Name:FLOYD I MILLER DPM PC
Entity Type:Organization
Organization Name:FLOYD I MILLER DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:I
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:480-545-2610
Mailing Address - Street 1:2175 N ALMA SCHOOL RD STE C109
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2880
Mailing Address - Country:US
Mailing Address - Phone:480-219-3766
Mailing Address - Fax:480-219-3768
Practice Address - Street 1:2175 N ALMA SCHOOL RD STE C109
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2880
Practice Address - Country:US
Practice Address - Phone:480-219-3766
Practice Address - Fax:480-219-3768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDG0183OtherRR MEDICARE
AZ114199Medicare PIN
AZ6002400001Medicare NSC