Individual
MILLARD PHILLIP THALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2150 S DOBSON ROAD, STE #1, MESA, AZ 85202
(480) 820-2974
(480) 897-0820
Mailing address
2150 S DOBSON ROAD, STE #1, MESA, AZ 85202
(480) 820-9774
(480) 897-0820
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
13111
AZ
207N00000X
Dermatology Physician
G-34444
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0032750
BCBS
—
Enumeration date
08/21/2006
Last updated
03/15/2021
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