Individual
CLYDE KENNEDY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
255 HWY 187, HATCH, NM 87937-0370
(505) 267-3286
(505) 267-1747
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(505) 267-3286
(505) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2007-0136
NM
Other
Enumeration date
06/18/2007
Last updated
07/08/2007
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