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Individual

MR. MATTHEW A MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1211 SOUTH GLOSTER ST, SUITE A, TUPELO, MS 38801
(662) 767-4200
(662) 767-4204
Mailing address
1211 SOUTH GLOSTER ST, SUITE A, TUPELO, MS 38801
(662) 767-4200
(662) 767-4204

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
T-2577
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06835533
MS
Enumeration date
07/02/2012
Last updated
02/01/2021
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