Provider Demographics
NPI:1396906558
Name:MILLER, DOUGLAS EUGENE (RPH)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:EUGENE
Last Name:MILLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9961 E SABINO SPRINGS PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-7102
Mailing Address - Country:US
Mailing Address - Phone:520-825-4874
Mailing Address - Fax:
Practice Address - Street 1:599 W 4TH ST
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:AZ
Practice Address - Zip Code:85602-6501
Practice Address - Country:US
Practice Address - Phone:520-586-7323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist