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General NPI Number Information
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NPI Number | 1518968155
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Entity Type | Individual
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Provider Name | OTIS E MILLER II
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Gender | Male
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Dates
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Enumeration Date | 08/04/2005
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 700 W 31ST ST STE 1001
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City | KANSAS CITY
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State | MO
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Zip | 64108-3633
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Country | US
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Telephone | 913-269-2036
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Fax |
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Provider Business Mailing Address
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Address Line | 700 W 31ST ST STE 1001
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City | KANSAS CITY
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State | MO
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Zip | 64108-3633
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Country | US
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Telephone | 913-269-2036
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 04-28117
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2024008707
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License Number State | MO
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