Individual
DR. DALLAS MARK MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2704 N OAK ST, BUILDING F, VALDOSTA, GA 31602-1744
(229) 242-4996
(229) 242-2306
Mailing address
2704 N OAK ST, BUILDING F, VALDOSTA, GA 31602-1744
(229) 242-4996
(229) 242-2306
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
026898
GA
2086S0129X
Vascular Surgery Physician
026898
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000396492A
—
GA
Enumeration date
02/13/2006
Last updated
09/20/2012
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