Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 04-25449 | KS |
NPI | 1023088200 |
---|---|
Provider Name | Dr. Christopher D Miller |
First Address | Wichita, KS 67205 |
Second Address | Wichita, KS 67205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 27/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100171080A | (05) | KS |
F60227 | (02) | KS |