Dr. Mark D. Miller
Dentist Anesthesiologist Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
1211 W Broadway Unit 106
Louisville
, Kentucky 40203-2082
Dr. Mark D. Miller
Dentist Anesthesiologist Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
1211 W Broadway Unit 106
Louisville
, Kentucky 40203-2082
(270) 889-3686
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About
Features
Specialties
- Dentist Anesthesiologist
- Oral and Maxillofacial Surgeon
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Mark D. Miller
- 15142 Rosario Rd
- Frisco, TX
- Zip : 75035-5439
- Phone : (270) 889-3686
Second Address
- Dr. Mark D. Miller
- 1211 W Broadway Unit 106
- Louisville, KY
- Zip : 40203-2082
- Fax : (270) 886-2224
- Phone : (270) 885-0165
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 1223D0004X | Dentist Anesthesiologist | 6861 | KY |
| N | 1223S0112X | Oral and Maxillofacial Surgeon | 36087 | TX |
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 6861 | KY |
| N | 204E00000X | Oral & Maxillofacial Surgeon | 6861 | KY |
National Provider Identifier
| NPI | 1104982016 |
|---|---|
| Provider Name | Dr. Mark D. Miller |
| First Address | Frisco, TX 75035-5439 |
| Second Address | Louisville, KY 40203-2082 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/12/2006 |
| Last Update Date | 24/06/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 60068616 | (05) | KY |
| 64068612 | (05) | KY |
| U50597 | (02) | KY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.