Healthcare Provider Details

I. General information

NPI: 1417963901
Provider Name (Legal Business Name): JUDITH C MILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JUDITH MILLER, MD JUDITH MILLER, MD

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/12/2020
Certification Date: 04/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N HIGLEY RD
GILBERT AZ
85234-1604
US

IV. Provider business mailing address

4728 E BIGHORN AVE
PHOENIX AZ
85044-4919
US

V. Phone/Fax

Practice location:
  • Phone: 530-332-7330
  • Fax:
Mailing address:
  • Phone: 559-281-2856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number33788
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberG64223
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: