Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 0548 | AZ |
NPI | 1053461053 |
---|---|
Provider Name | Floyd I Miller |
First Address | Chandler, AZ 85224-2880 |
Second Address | Chandler, AZ 85224-2880 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 29/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2Z0121 | HEALTHNET OF AZ (01) | AZ |
612459 | (05) | AZ |
P00409461 | RR MEDICARE (01) | AZ |
U81666 | (02) |