Individual
LON MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4120 W SOFT WIND DR, GLENDALE, AZ 85310-4000
(509) 336-3775
(623) 547-7196
Mailing address
4120 W SOFT WIND DR, GLENDALE, AZ 85310-4000
(509) 336-3775
(623) 547-7196
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M6077
ID
207P00000X
Emergency Medicine Physician
MD00030099
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003836400
—
ID
05
—
8167116
—
WA
Enumeration date
07/26/2006
Last updated
10/27/2011
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