Healthcare Provider Details

I. General information

NPI: 1790799229
Provider Name (Legal Business Name): ROBERT R MILLER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 S MAYO TRL
PAINTSVILLE KY
41240-1220
US

IV. Provider business mailing address

1709 KY ROUTE 321 STE 3
PRESTONSBURG KY
41653-9097
US

V. Phone/Fax

Practice location:
  • Phone: 606-887-6145
  • Fax: 844-464-1174
Mailing address:
  • Phone: 606-886-8546
  • Fax: 606-886-8548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number00235
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: