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NPI Code Detail

MEDICARE: ROBERT L MILLER OD

MEDICARE:   ROBERT L MILLER  OD
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
1152W00000XOptometrist4371OH

General Provider Information

NPI Number : 1073682076
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT L MILLER OD
Provider Business Mailing Address
First Line : 500 S PROSPECT AVE
Second Line :
City : HARTVILLE
State : OH
Zip : 44632-9403
Country : US
Telephone Number : 330-877-2117
Fax Number : 330-877-1617
Provider Business Practice Location Address
First Line : 500 S PROSPECT AVE
Second Line :
City : HARTVILLE
State : OH
Zip : 44632-9403
Country : US
Telephone Number : 330-877-2117
Fax Number : 330-877-1617
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2006
Last Update Date : 07/08/2007

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Directions to “ ROBERT L MILLER OD” Practice Location

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