Provider Demographics
NPI:1194352484
Name:MILLER, PAUL ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ALLEN
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25261 LA MAR RD APT C
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3023
Mailing Address - Country:US
Mailing Address - Phone:423-650-2317
Mailing Address - Fax:
Practice Address - Street 1:1924 ALCOA HWY # U-107
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1511
Practice Address - Country:US
Practice Address - Phone:865-305-8685
Practice Address - Fax:865-305-9338
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program