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Individual

DR. LAURENCE IRWIN MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
506 ROSEWOOD DR, KIRKSVILLE, MO 63501-2437
(660) 665-1223
(660) 665-2566
Mailing address
506 ROSEWOOD DR, KIRKSVILLE, MO 63501-2437
(660) 665-1223
(660) 665-2566

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
02394
IA
207W00000X
Ophthalmology Physician
Primary
33564
MO
207W00000X
Ophthalmology Physician
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0945857
IA
01
13028
BC/BS
MO
01
36470
BC/BS
IA
Enumeration date
10/25/2005
Last updated
02/04/2008
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