Provider Demographics
NPI:1063601573
Name:KEVIN MILES, D.O., LTD.
Entity type:Organization
Organization Name:KEVIN MILES, D.O., LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:775-324-6300
Mailing Address - Street 1:PO BOX 17418
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-7418
Mailing Address - Country:US
Mailing Address - Phone:775-324-6300
Mailing Address - Fax:775-324-6301
Practice Address - Street 1:890 MILL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1442
Practice Address - Country:US
Practice Address - Phone:775-324-6300
Practice Address - Fax:775-324-6301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-20
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1221208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty