MEDICARE: DR. TIMOTHY H MILLER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	36415	TN
2	208VP0014X	Interventional Pain Medicine Physician	36415	TN

General Provider Information

NPI Number	:	1043218654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY H MILLER M.D.

Provider Business Mailing Address
First Line	:	3024 BUSINESS PARK CIR
Second Line	:
City	:	GOODLETTSVILLE
State	:	TN
Zip	:	37072-3132
Country	:	US
Telephone Number	:	615-239-2018
Fax Number	:

Provider Business Practice Location Address
First Line	:	5801 CROSSINGS BLVD
Second Line	:
City	:	ANTIOCH
State	:	TN
Zip	:	37013-3130
Country	:	US
Telephone Number	:	615-941-8501
Fax Number	:	615-941-8102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	04/12/2024

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