Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 18980 | MS |
NPI | 1053533406 |
---|---|
Provider Name | Dr. Richard Eric Miller |
First Address | Flowood, MS 39232-9506 |
Second Address | Brookhaven, MS 39601-2399 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 08/07/2007 |