Organization
LAKOTA MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM D MILES D.O. (PRESIDENT)
(513) 893-8000
Entity
Organization
Contact information
Practice address
1755 S ERIE HWY STE A, HAMILTON, OH 45011-4145
(513) 893-8000
(513) 893-8200
Mailing address
2466 TENNYSON DR, BELLBROOK, OH 45305-1744
(513) 893-8000
(937) 848-9106
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
34-004296
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000364512
ANTHEM BC BS
OH
Enumeration date
08/15/2006
Last updated
08/10/2009
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