Healthcare Provider Details

I. General information

NPI: 1982811352
Provider Name (Legal Business Name): TIMOTHY LEE MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 N HAMILTON RD
WESTERVILLE OH
43081-2062
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-3600
  • Fax: 614-685-9419
Mailing address:
  • Phone: 614-293-3600
  • Fax: 614-366-8846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number35092287
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: