Miller, Keith Wayne

Miller, Keith Wayne is an sole proprietor health care provider with primary practice located at 7011 Shallowford Rd Suite 103, Chattanooga TN 37421-6727. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Miller, Keith Wayne can be contacted via phone (423) 855-4567.

Contact Information

Primary practice address
7011 Shallowford Rd Suite 103 Chattanooga TN 37421-6727
Phone: (423) 855-4567
Fax: (423) 855-7946
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X DPM302 Tennessee

Profile Details

NPI number 1902973191
LBN Legal business name Miller, Keith Wayne
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902973191 NPPES
Tennessee MEDICAID 3351334

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