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General NPI Number Information
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NPI Number | 1619152337
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Entity Type | Organization
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Legal Business Name | RICHARD S MILES PSC
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Dates
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Enumeration Date | 12/31/2007
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Last Update Date | 12/31/2007
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Provider Practice Location Address
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Address Line | 124 DOWELL RD
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City | RUSSELL SPGS
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State | KY
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Zip | 42642
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Country | US
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Telephone | 270-866-2440
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Fax | 270-866-2442
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Provider Business Mailing Address
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Address Line | 124 DOWELL RD
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City | RUSSELL SPGS
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State | KY
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Zip | 42642
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Country | US
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Telephone | 270-866-2440
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Fax | 270-866-2442
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Authorized Official
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Title or Position | PRESIDENT OWNER MD
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Name | DR. RICHARD S MILES
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Credential | MD
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Telephone | 270-866-2440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 19700
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License Number State | KY
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