| Miller Family Medical Center | |
|
4707 Woodridge Dr Memphis TN 38116-7811 | |
| (901) 345-5411 | |
| Not Available |
| Full Name | Miller Family Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 4707 Woodridge Dr, Memphis, Tennessee |
| Authorized Official Name and Position | Logan E Miller (PRESIDENT) |
| Authorized Official Contact | 9013455411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miller Family Medical Center 4707 Woodridge Dr Memphis TN 38116-7811 Ph: (901) 345-5411 | Miller Family Medical Center 4707 Woodridge Dr Memphis TN 38116-7811 Ph: (901) 345-5411 |
| NPI Number | 1295935708 |
|---|---|
| Provider Enumeration Date | 07/23/2007 |
| Last Update Date | 07/23/2007 |
| Medicare PECOS PAC ID | 1557394699 |
|---|---|
| Medicare Enrollment ID | O20050919000091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295935708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 17217 (Tennessee) | Primary |
| Provider Name | Rosemary J Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609949023 PECOS PAC ID: 3779563481 Enrollment ID: I20040726001367 |
| Provider Name | Logan E Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174696595 PECOS PAC ID: 1456384593 Enrollment ID: I20111028000004 |
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