Individual
TIMOTHY W MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1000 GREG KRUSCHEK HIGHWAY, NORTON SOUND HEALTH CORP., NOME, AK 99762
(907) 443-3311
Mailing address
PO BOX 1209, NOME, AK 99762
(907) 433-9500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5233
AK
207Q00000X
Family Medicine Physician
Primary
7891
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7891
ALASK STATE MEDICAL LICENCE (OLD 5233, NEW 7891)
AK
Enumeration date
06/19/2009
Last updated
08/04/2015
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