Individual
MARK A MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1170 ROYAL AVE, MEDFORD, OR 97504-6101
(541) 779-7331
(541) 779-3522
Mailing address
1170 ROYAL AVE, MEDFORD, OR 97504-6101
(541) 779-7331
(402) 559-8940
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD204536
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500793096
—
OR
Enumeration date
06/29/2016
Last updated
08/03/2021
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