Healthcare Provider Details

I. General information

NPI: 1396991063
Provider Name (Legal Business Name): DENNIS W. MILLER, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2008
Last Update Date: 08/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 N 12TH ST STE 350
KANSAS CITY KS
66102-5172
US

IV. Provider business mailing address

21 N 12TH ST STE 350
KANSAS CITY KS
66102-5172
US

V. Phone/Fax

Practice location:
  • Phone: 913-371-1667
  • Fax: 913-371-2798
Mailing address:
  • Phone: 913-371-1667
  • Fax: 913-371-2798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number04-19490
License Number StateKS

VIII. Authorized Official

Name: DR. DENNIS W. MILLER
Title or Position: MD/OWNER
Credential: MD
Phone: 913-371-1667