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NPI Code Detail

MEDICARE: DEREK W MILLER DPT

MEDICARE:   DEREK W MILLER  DPT
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
1225100000XPhysical Therapist16883

General Provider Information

NPI Number : 1508726308
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEREK W MILLER DPT
Provider Business Mailing Address
First Line : 1315 CARRBERRY CT
Second Line :
City : KINGSPORT
State : TN
Zip : 37663-3777
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1732 N EASTMAN RD STE 1A
Second Line :
City : KINGSPORT
State : TN
Zip : 37664-2376
Country : US
Telephone Number : 423-390-8948
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2025
Last Update Date : 01/05/2026

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Directions to “ DEREK W MILLER DPT” Practice Location

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