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NPI Code Detail

MEDICARE: MOLLIE T MILLER

MEDICARE: MOLLIE T MILLER
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
1207V00000XObstetrics & Gynecology PhysicianDR.0048291CO
2207VX0000XObstetrics PhysicianDR.0048291CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
148291OTHERCOSTATE LICENSE

General Provider Information

NPI Number : 1053638064
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLIE T MILLER
Provider Business Mailing Address
First Line : DEPT 1057
Second Line :
City : DENVER
State : CO
Zip : 80291-1057
Country : US
Telephone Number : 303-486-5500
Fax Number : 303-486-5502
Provider Business Practice Location Address
First Line : 1338 PHAY AVE
Second Line :
City : CANON CITY
State : CO
Zip : 81212-2311
Country : US
Telephone Number : 719-285-2700
Fax Number : 719-285-2455
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2010
Last Update Date : 12/16/2025

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Directions to “ MOLLIE T MILLER ” Practice Location

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