Healthcare Provider Details

I. General information

NPI: 1013900273
Provider Name (Legal Business Name): THOMAS ROBERT MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 08/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3734 MARTIN MILL PIKE
KNOXVILLE TN
37920-2453
US

IV. Provider business mailing address

1932 ALCOA HWY C 460
KNOXVILLE TN
37920-1527
US

V. Phone/Fax

Practice location:
  • Phone: 865-579-5322
  • Fax: 865-579-5329
Mailing address:
  • Phone: 865-546-9246
  • Fax: 865-523-6466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD11224
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: