Individual
KENNETH DAVID MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11165 HERITAGE OAKS, SHREVEPORT, LA 71106-8383
(318) 797-7353
(318) 797-3460
Mailing address
11165 HERITAGE OAKS, SHREVEPORT, LA 71106-8383
(318) 797-7353
(318) 797-3460
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
021112
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1975796
—
LA
Enumeration date
06/07/2006
Last updated
04/29/2011
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