Individual
JOAN D MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5171 S. COTTONWOOD ST, STE 610, BUILDING 1, SUITE 610, MURRAY, UT 84107-8410
(801) 507-3630
(801) 507-3898
Mailing address
5121 S COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-3630
(801) 507-3898
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
9005425-1205
UT
2086X0206X
Surgical Oncology Physician
Primary
9005425-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0294913
L&I
WA
05
—
1376764282
—
WA
Enumeration date
05/01/2007
Last updated
04/14/2021
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