Individual
STEPHEN MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-6632
Mailing address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
311802
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2016
Last updated
04/23/2020
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