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NPI Code Detail

MEDICARE: TANNER M MILLER M.D.

MEDICARE: TANNER M MILLER M.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
1207R00000XInternal Medicine Physician036146339IL

General Provider Information

NPI Number : 1497135065
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANNER M MILLER M.D.
Provider Business Mailing Address
First Line : 800 E LOCUST ST
Second Line :
City : OLNEY
State : IL
Zip : 62450-2553
Country : US
Telephone Number : 618-395-7340
Fax Number : 618-395-2131
Provider Business Practice Location Address
First Line : 363 N WEST ST
Second Line :
City : OLNEY
State : IL
Zip : 62450-1160
Country : US
Telephone Number : 618-392-9400
Fax Number : 618-395-2131
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2015
Last Update Date : 12/23/2025

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Directions to “ TANNER M MILLER M.D.” Practice Location

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