Healthcare Provider Details

I. General information

NPI: 1447299011
Provider Name (Legal Business Name): ELIZABETH A MILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4720 WATERS AVE
SAVANNAH GA
31404-6292
US

IV. Provider business mailing address

PO BOX 102635
ATLANTA GA
30368-2635
US

V. Phone/Fax

Practice location:
  • Phone: 912-354-4800
  • Fax: 912-629-5821
Mailing address:
  • Phone: 912-354-4800
  • Fax: 912-629-5821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number029351
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number029351
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: