Individual
DR. THEODORE H MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PHD.
Contact information
Practice address
40 NORTH GRAND AVE., SUITE 101, FT. THOMAS, KY 41075
(859) 781-4900
(859) 781-3039
Mailing address
40 N GRAND AVE STE 103, FORT THOMAS, KY 41075-1765
(859) 781-4900
(859) 572-3039
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
25084
KY
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
25084
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000033216
ANTHEM BC/BS
—
05
—
64250848
—
OH
Enumeration date
10/26/2005
Last updated
04/27/2018
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