Individual
DR. KENNITH MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
156 W JEFFERSON ST, SPRING GREEN, WI 53588-8005
(608) 588-2600
(608) 588-2644
Mailing address
156 W JEFFERSON ST, SPRING GREEN, WI 53588-8005
(608) 588-2600
(608) 588-2644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
010090
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
245694807
—
MO
Enumeration date
02/07/2006
Last updated
10/02/2013
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