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General NPI Number Information
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NPI Number | 1548365562
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Entity Type | Individual
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Provider Name | KEITH C MILLER OD
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 03/29/2019
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Provider Practice Location Address
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Address Line | 3911 COFFEE RD STE B
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City | BAKERSFIELD
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State | CA
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Zip | 93308-5024
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Country | US
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Telephone | 661-588-8222
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Fax | 661-588-0222
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Provider Business Mailing Address
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Address Line | 11270 LIMA ST
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City | HENDERSON
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State | CO
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Zip | 80640
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Country | US
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Telephone | 303-386-4567
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2299
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 13897TG
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License Number State | CA
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