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General NPI Number Information
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NPI Number | 1184653412
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Entity Type | Individual
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Provider Name | PHILIP ALEXANDER MILLER PA
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2501 W 22ND ST
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City | SIOUX FALLS
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State | SD
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Zip | 57105-1305
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Country | US
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Telephone | 605-333-5318
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Fax | 605-373-4119
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Provider Business Mailing Address
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Address Line | 5212 E 17TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57110-3137
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Country | US
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Telephone | 605-336-3230
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Fax | 605-373-4119
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0465
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License Number State | SD
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