MEDICARE: ROBERT G 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	207Q00000X	Family Medicine Physician	18647	TN

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
2	4198150	OTHER	TN	BCBS OF TN

General Provider Information

NPI Number	:	1639142524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT G MILLER MD

Provider Business Mailing Address
First Line	:	2996 KATE BOND RD STE 405
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38133-4063
Country	:	US
Telephone Number	:	870-394-4832
Fax Number	:	866-345-0188

Provider Business Practice Location Address
First Line	:	2996 KATE BOND RD STE 405
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38133-4063
Country	:	US
Telephone Number	:	870-394-4832
Fax Number	:	866-345-0188

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

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	05/01/2018

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