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Individual

RICKY MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
602 N ACADIA RD, THIBODAUX, LA 70301-4823
(985) 435-4831
(985) 449-2585
Mailing address
1924 ALCOA HWY # U-11, KNOXVILLE, TN 37920-1511
(865) 305-9230
(865) 305-8894

Taxonomy

Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
322505
LA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/25/2013
Last updated
07/08/2020
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