Healthcare Provider Details

I. General information

NPI: 1912195231
Provider Name (Legal Business Name): ANTHONY JOSEPH MILLIANO SR. AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4570 PECAN DR STE A
PADUCAH KY
42001-6717
US

IV. Provider business mailing address

4570 PECAN DR STE A
PADUCAH KY
42001-6717
US

V. Phone/Fax

Practice location:
  • Phone: 270-554-6000
  • Fax:
Mailing address:
  • Phone: 270-554-6000
  • Fax: 270-554-6995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberKY0245
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberKY0632
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: