Provider Demographics
NPI:1942272596
Name:MILLER, RICHARD MERTON (DO)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:MERTON
Last Name:MILLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 N LOGAN AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-4360
Mailing Address - Country:US
Mailing Address - Phone:217-477-4738
Mailing Address - Fax:217-444-4972
Practice Address - Street 1:707 N LOGAN AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-4360
Practice Address - Country:US
Practice Address - Phone:217-477-4738
Practice Address - Fax:217-444-4972
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002592A207X00000X
OH34007276M207X00000X
IL036176883207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200046241OtherRAILROAD MEDICARE
IN200440250Medicaid
OH2210093Medicaid
INH19699Medicare UPIN
OHMI4031793Medicare PIN
OHMI4031793Medicare PIN