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General NPI Number Information
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NPI Number | 1396777462
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Entity Type | Individual
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Provider Name | CALVIN L MILLER MD
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 01/14/2010
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Provider Practice Location Address
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Address Line | 110 MED TECH PKWY
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City | JOHNSON CITY
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State | TN
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Zip | 37604-4004
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Country | US
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Telephone | 423-722-0360
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Fax | 423-793-1339
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Provider Business Mailing Address
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Address Line | 225 MIDWAY MEDICAL PARK
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City | BRISTOL
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State | TN
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Zip | 37620-1680
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Country | US
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Telephone | 423-722-0360
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Fax | 423-793-1339
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD0000016717
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License Number State | TN
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