Individual
DR. RICHARD STAYTON MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
124 DOWELL RD, RUSSELL SPRINGS, KY 42642-4278
(270) 866-2440
(270) 866-2442
Mailing address
124 DOWELL RD, RUSSELL SPRINGS, KY 42642-4278
(270) 866-2440
(270) 866-2442
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19700
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000047852
ANTHEM BCBS
—
01
—
080189178
PALMETTO GBA RR MEDICARE
—
05
—
64197007
—
KY
Enumeration date
05/10/2006
Last updated
10/28/2009
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