=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053461053
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FLOYD I MILLER DPM
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/11/2007
-----------------------------------------------------
Last Update Date | 02/15/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2175 N ALMA SCHOOL RD STE C109
-----------------------------------------------------
City | CHANDLER
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85224-2880
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-545-2610
-----------------------------------------------------
Fax | 480-545-2673
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2034 E SOUTHERN AVE STE W
-----------------------------------------------------
City | TEMPE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85282-7519
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-219-3766
-----------------------------------------------------
Fax | 480-219-3768
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | 0548
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------