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General NPI Number Information
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NPI Number | 1386714616
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Entity Type | Organization
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Legal Business Name | OPHTHALMOLOGY ASSOCIATES PA
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 310 N SMITH AVE RITCHIE MEDICAL PLAZA SUITE 100
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City | ST PAUL
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State | MN
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Zip | 55102-2384
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Country | US
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Telephone | 651-293-0225
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Fax | 651-293-0329
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Provider Business Mailing Address
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Address Line | 310 N SMITH AVE RITCHIE MEDICAL PLAZA SUITE 100
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City | ST PAUL
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State | MN
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Zip | 55102-2384
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Country | US
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Telephone | 651-293-0225
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Fax | 651-293-0329
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEORGE ERNEST MILLER
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Credential | MD
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Telephone | 651-293-0225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 20294
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License Number State | MN
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