Individual
MARK DANIEL MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4271
(859) 258-4418
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-6200
(859) 258-6203
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
28222
WV
208600000X
Surgery Physician
Primary
58412
KY
208600000X
Surgery Physician
TP657
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100440870
—
KY
Enumeration date
04/22/2013
Last updated
09/25/2023
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