Individual
DR. RANDY KING MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
25376 STATE HIGHWAY 39, STE 301, SHELL KNOB, MO 65747-7343
(417) 236-2680
(417) 236-2683
Mailing address
3800 S NATIONAL AVE, STE 540, SPRINGFIELD, MO 65807-5209
(417) 269-5712
(417) 269-4869
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MO115530
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
249997503
—
MO
Enumeration date
01/18/2007
Last updated
12/28/2010
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