Organization
IOWA ILLINOIS PAIN CONSULTANTS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY JON MILLER MD (PRESIDENT)
(563) 424-0512
Entity
Organization
Contact information
Practice address
3385 DEXTER CT, STE 300, DAVENPORT, IA 52807-3494
(563) 424-0512
(563) 326-6236
Mailing address
PO BOX 580, BETTENDORF, IA 52722-0010
(563) 424-0512
(563) 326-6236
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
26118
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036079595
—
IL
01
—
14316
BLUE CROSS BLUE SHIELD
IA
05
—
4024711
—
IA
Enumeration date
04/29/2008
Last updated
03/02/2015
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