Basic Information
| Provider Information | |||||||||
| NPI: | 1417059445 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | MILES | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 995 HWY 93 S | ||||||||
| Address2: | |||||||||
| City: | EUREKA | ||||||||
| State: | MT | ||||||||
| PostalCode: | 59917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062972438 | ||||||||
| FaxNumber: | 4062973374 | ||||||||
| Practice Location | |||||||||
| Address1: | 995 HWY 93 S | ||||||||
| Address2: | |||||||||
| City: | EUREKA | ||||||||
| State: | MT | ||||||||
| PostalCode: | 59917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062972438 | ||||||||
| FaxNumber: | 4062973374 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 71 | MT | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.