Individual
DAVID MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1309 BENNETT AVE, BURLEY, ID 83318
(208) 678-7796
(208) 678-7799
Mailing address
794 EASTLAND DR, TWIN FALLS, ID 83301-6856
(208) 734-3312
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-1095
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164834040
NPI
—
Enumeration date
05/27/2014
Last updated
03/17/2021
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