MEDICARE: DR. LEON MILLER MD

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	208600000X	Surgery Physician	35057776	OH
2	208600000X	Surgery Physician	16955	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164432217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEON MILLER MD

Provider Business Mailing Address
First Line	:	1261 WOOSTER RD
Second Line	:	SUITE 215
City	:	MILLERSBURG
State	:	OH
Zip	:	44654-1570
Country	:	US
Telephone Number	:	330-674-7777
Fax Number	:	330-674-2084

Provider Business Practice Location Address
First Line	:	1261 WOOSTER RD
Second Line	:	SUITE 215
City	:	MILLERSBURG
State	:	OH
Zip	:	44654-1570
Country	:	US
Telephone Number	:	330-674-7777
Fax Number	:	330-674-2084

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	03/12/2014

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Directions to “ DR. LEON MILLER MD” Practice Location

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