Healthcare Provider Details

I. General information

NPI: 1033118765
Provider Name (Legal Business Name): RODNEY A MILLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 02/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1261 WOOSTER RD SUITE 120
MILLERSBURG OH
44654-1568
US

IV. Provider business mailing address

3373 COMMERCE PKWY SUITE 2
WOOSTER OH
44691-7130
US

V. Phone/Fax

Practice location:
  • Phone: 330-674-0775
  • Fax: 330-674-0786
Mailing address:
  • Phone: 330-804-9712
  • Fax: 330-804-9717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35065767
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: