Healthcare Provider Details

I. General information

NPI: 1326275082
Provider Name (Legal Business Name): TIMOTHY W MILLER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2009
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12350 INDUSTRY WAY STE 160
ANCHORAGE AK
99515-4300
US

IV. Provider business mailing address

3801 LAKE OTIS PKWY STE 300
ANCHORAGE AK
99508-5234
US

V. Phone/Fax

Practice location:
  • Phone: 907-345-4343
  • Fax: 907-345-6232
Mailing address:
  • Phone: 907-562-2277
  • Fax: 907-563-3460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7891
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: