Healthcare Provider Details

I. General information

NPI: 1124094891
Provider Name (Legal Business Name): JOAN MILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOAN MILLER MD

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 09/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2165 9TH ST W BOX 1459
COLUMBIA FALLS MT
59912-4416
US

IV. Provider business mailing address

1600 HOSPITAL WAY
WHITEFISH MT
59937-7849
US

V. Phone/Fax

Practice location:
  • Phone: 406-892-3208
  • Fax:
Mailing address:
  • Phone: 406-863-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3255
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: