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Individual

MR. KENNETH T. MILLER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
160A W TENNESSE AVE, OAK RIDGE, TN 37830-6940
(865) 835-3740
(865) 385-3742
Mailing address
969 OAK RIDGE TURNPIKE, PMB 222, OAK RIDGE, TN 37830-8832
(865) 482-4028
(865) 481-3257

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD0000010495
TN
174400000X
Specialist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3163832
TN
Enumeration date
06/15/2006
Last updated
07/15/2015
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