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NPI Code Detail

MEDICARE: DR. KIM PATRICIA MILLER PH.D.

MEDICARE: DR. KIM PATRICIA MILLER PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103G00000XClinical Neuropsychologist016390NY
2103TC0700XClinical Psychologist016390NY
3103TC0700XClinical PsychologistPSY004728GA

General Provider Information

NPI Number : 1053319947
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIM PATRICIA MILLER PH.D.
Provider Business Mailing Address
First Line : 23 WINTHROP DR
Second Line :
City : SHARPSBURG
State : GA
Zip : 30277-2285
Country : US
Telephone Number : 347-204-4629
Fax Number : 470-414-1096
Provider Business Practice Location Address
First Line : 3355 LENOX RD NE STE 1000
Second Line :
City : ATLANTA
State : GA
Zip : 30326-2000
Country : US
Telephone Number : 770-284-1044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 06/24/2025

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