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Organization

STEPHEN A. MILLER,D.O.,P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHEN ALAN MILLER D.O. (OWNER)
(620) 251-0777
Entity
Organization

Contact information

Practice address
1717 W 8TH ST, COFFEYVILLE, KS 67337-3101
(620) 251-0777
(620) 251-4173
Mailing address
1717 WEST 8TH, COFFEYVILLE, KS 67337-3101
(620) 251-0777
(620) 251-4173

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
0521872
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100206010B
KS
Enumeration date
04/26/2012
Last updated
04/26/2012
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