MEDICARE: DR. JOHN T MILLER MD

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
1	207RC0000X	Cardiovascular Disease Physician	R4F76	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00117065	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12565062	OTHER		BCBS OF KC INDIVIDUAL #

General Provider Information

NPI Number	:	1417920158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN T MILLER MD

Provider Business Mailing Address
First Line	:	9411 N OAK TRFY
Second Line	:	SUITE LL1
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-2262
Country	:	US
Telephone Number	:	816-436-7072
Fax Number	:	816-436-2743

Provider Business Practice Location Address
First Line	:	2790 CLAY EDWARDS DR
Second Line	:	SUITE 520
City	:	NORTH KANSAS CITY
State	:	MO
Zip	:	64116-3276
Country	:	US
Telephone Number	:	816-221-6750
Fax Number	:	816-221-7280

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	10/22/2007

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Directions to “ DR. JOHN T MILLER MD” Practice Location

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