Healthcare Provider Details

I. General information

NPI: 1275943151
Provider Name (Legal Business Name): LAURA MILLER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7502 STATE RD STE 4400
CINCINNATI OH
45255-2801
US

IV. Provider business mailing address

7502 STATE RD
CINCINNATI OH
45255-2596
US

V. Phone/Fax

Practice location:
  • Phone: 513-936-0500
  • Fax: 513-936-0600
Mailing address:
  • Phone: 513-936-0500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number5101020918
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number34.014052
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: