Individual
KENNETH R MILLER
Active
Individual
KENNETH R MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
8816
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0166707
UMWA
OK
05
—
100104840A
—
OK
01
—
1324230001
PALMETTO DME
OK
01
—
730710406020
BC/BS
OK
01
—
731310891006
UNICARE
OK
01
—
7313108931028
TRICARE SOUTH
OK
01
—
74502A010
CHAMPUS (WPS)
OK
01
—
D35047
STERLING OPTION 1
OK
Enumeration date
04/10/2006
Last updated
08/15/2012
Update your record
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