Individual
DR. MARVIN TYRONE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(731) 541-8154
(731) 541-6068
Mailing address
PO BOX 400, JACKSON, TN 38302-0400
(731) 425-5752
(731) 425-5783
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD026576
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD026576
MEDICAL LICENSE
TN
05
—
Q007372
—
TN
Enumeration date
07/22/2005
Last updated
03/25/2015
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