Individual
MR. GARY A MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 MEDICAL CENTER DR, PADUCAH, KY 42003-7909
(270) 442-1024
Mailing address
140 ROSEMONT DR, PADUCAH, KY 42001-9276
(573) 686-5550
(573) 686-2136
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1029996
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000318171
KY BCBS INDIVIDUAL
KY
05
—
74353079
—
KY
01
—
P00060094
RR MEDICARE
KY
Enumeration date
10/06/2005
Last updated
04/02/2008
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