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General NPI Number Information
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NPI Number | 1225066418
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Entity Type | Individual
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Provider Name | KENNETH JOSEPH MILLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 12/28/2015
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Provider Practice Location Address
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Address Line | 32 BAY FRONT PL
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City | HAMPTON
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State | VA
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Zip | 23664-1791
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Country | US
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Telephone | 614-832-8392
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Fax | 888-383-3873
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Provider Business Mailing Address
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Address Line | 32 BAY FRONT PL
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City | HAMPTON
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State | VA
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Zip | 23664-1791
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Country | US
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Telephone | 614-832-8392
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Fax | 888-383-3873
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35.049517
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C41166
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101253992
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD33125
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License Number State | SC
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