MEDICARE: MILLER EYE CARE PC

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	152W00000X	Optometrist	TNOD1234	TN

General Provider Information

NPI Number	:	1396925558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLER EYE CARE PC

Provider Business Mailing Address
First Line	:	9409 S NORTHSHORE DR
Second Line	:	SUITE 101
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-6550
Country	:	US
Telephone Number	:	865-694-2622
Fax Number	:	865-694-2650

Provider Business Practice Location Address
First Line	:	9409 S NORTHSHORE DR
Second Line	:	SUITE 101
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-6550
Country	:	US
Telephone Number	:	865-694-2622
Fax Number	:	865-694-2650

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID H MILLER
Credential	:	O.D.
Telephone Number	:	865-694-2622

Provider Enumeration Date	:	11/05/2007
Last Update Date	:	05/07/2009

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