Individual
KEITH D. MILLIRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
200 S MAIN ST, DU BOIS, PA 15801-1578
(814) 375-0125
(814) 375-2291
Mailing address
200 S MAIN ST, DU BOIS, PA 15801-1578
(814) 375-0125
(814) 375-2291
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000781
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001360500
BLUE SHIELD
—
01
—
251369033
TRICARE
PA
01
—
316734
UPMC
PA
Enumeration date
01/06/2006
Last updated
12/16/2009
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