1356512388 NPI number — WILLIAM A. MILLER D.C.P.A.

Table of content: (NPI 1356512388)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356512388 NPI number — WILLIAM A. MILLER D.C.P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM A. MILLER D.C.P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356512388
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2201 W 25TH ST
Provider Second Line Business Mailing Address:
STE. U
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66047-2958
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-842-4114
Provider Business Mailing Address Fax Number:
785-842-7870

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2201 W 25TH ST
Provider Second Line Business Practice Location Address:
STE. U
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66047-2958
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-842-4114
Provider Business Practice Location Address Fax Number:
785-842-7870
Provider Enumeration Date:
03/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
AARON
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
785-842-4114

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  C3221 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 007238 . This is a "BCBS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 82177 . This is a "COVENTRY" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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