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NPI Code Detail

MEDICARE: MR. BRIAN KEITH MILLER PHARMD

MEDICARE: MR. BRIAN KEITH MILLER PHARMD
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
1183500000XPharmacistRPH022454GA

General Provider Information

NPI Number : 1366726069
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN KEITH MILLER PHARMD
Provider Business Mailing Address
First Line : 1280 COTTON GIN DR
Second Line :
City : POWDER SPRINGS
State : GA
Zip : 30127-6451
Country : US
Telephone Number : 678-402-8778
Fax Number :
Provider Business Practice Location Address
First Line : 4519 DALLAS ACWORTH HWY
Second Line :
City : DALLAS
State : GA
Zip : 30132-7675
Country : US
Telephone Number : 770-443-4988
Fax Number : 770-443-4487
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2011
Last Update Date : 09/29/2011

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