Healthcare Provider Details

I. General information

NPI: 1609363514
Provider Name (Legal Business Name): AMY LEIGH MILLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY LEIGH FLETCHER M.D.

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 W COURT ST STE C
PARAGOULD AR
72450-4247
US

IV. Provider business mailing address

630 W COURT ST STE C
PARAGOULD AR
72450-4247
US

V. Phone/Fax

Practice location:
  • Phone: 870-236-6911
  • Fax: 870-236-8129
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE14145
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: