Individual
FRED P MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
425 IDAHO STREET, GOODING, ID 83330
(208) 934-5900
(208) 934-5719
Mailing address
PO BOX 447, GOODING, ID 83330
(208) 934-5900
(208) 934-5719
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NP104
ID
Other
Enumeration date
04/19/2006
Last updated
03/05/2018
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