Provider Demographics
NPI:1124355219
Name:GEORGE E. MILLER
Entity type:Organization
Organization Name:GEORGE E. MILLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-961-4335
Mailing Address - Street 1:3747 W FORK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-7548
Mailing Address - Country:US
Mailing Address - Phone:513-961-4335
Mailing Address - Fax:513-961-4227
Practice Address - Street 1:20 MEDICAL VILLAGE DR
Practice Address - Street 2:SUITE 338
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-5401
Practice Address - Country:US
Practice Address - Phone:859-341-5035
Practice Address - Fax:859-341-9080
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRANLEY SURGICAL ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-10
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17684208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64-176845Medicaid
KYC69638OtherUPIN
KY1048601Medicare PIN