Provider Demographics
NPI:1972580231
Name:MILLER, THOMAS KEVIN (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:KEVIN
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2331 FRANKLIN RD SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-1111
Mailing Address - Country:US
Mailing Address - Phone:540-725-1226
Mailing Address - Fax:540-857-5306
Practice Address - Street 1:2331 FRANKLIN RD SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-1111
Practice Address - Country:US
Practice Address - Phone:540-725-1226
Practice Address - Fax:540-857-5306
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039733207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA149858904OtherOWCP
VA1972580231OtherVIRGINIA HEALTH NETWORK
VA1972580231OtherUNITED HEALTHCARE
VA1972580231OtherHEALTHKEEPERS
VA1972580231Medicaid
VA3810018721OtherMEDICAID OF WEST VIRGINIA
VAP00831110OtherRAILROAD MEDICARE
VA1972580231OtherVA PREMIER
VA1972580231OtherCIGNA
VA1972580231OtherSOUTHERN HEALTH/CARENET/CARELINK/COVENTRY
VA1972580231OtherUMWA
VA1972580231OtherOPTIMA HEALTH PLAN
VA540506332005OtherTRICARE/CHAMPUS
VA1972580231OtherAETNA
VA1972580231OtherHUMANA MEDICARE
VA1972580231OtherHEALTHKEEPERS PLUS
VA1972580231OtherGATEWAY
VA1972580231OtherANTHEM
VA1972580231OtherINTOTAL
VA1972580231OtherBLACK LUNG
VA1972580231OtherHEALTHKEEPERS PLUS
VA3810018721OtherMEDICAID OF WEST VIRGINIA
VA1972580231OtherOPTIMA HEALTH PLAN