| Kenneth L Miller, MD | |
|
1101 W Liberty, Parkland Health Center Dept Of Radiology, Farmington, MO 63640 | |
| (573) 760-8075 | |
| (573) 760-8358 |
| Full Name | Kenneth L Miller |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 38 Years |
| Location | 1101 W Liberty, Farmington, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992715122 | NPI | - | NPPES |
| 109972 | Other | LICENSE NUMBER | |
| 8707 | Other | HEALTHCARE | |
| 945K1 | Other | MO BLUE | |
| 14989V14989 | Other | GHP | |
| 290568 | Other | CMR | |
| 290568 | Other | HL | |
| G23727 | Other | NATIONAL REGISTRY NUMBER | |
| 290568 | Other | AMER MEDSE | |
| 945K1 | Other | MO | BCBS MO |
| 945K1 | Other | IL BLUE | |
| STL1600408 | Other | UHC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 109972 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Parkland Health Center | Farmington, MO | Hospital |
| Iron County Medical Center | Pilot knob, MO | Hospital |
| Mercy Hospital Jefferson | Festus, MO | Hospital |
| Barnes Jewish Hospital | Saint louis, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Nrg-parkland Llc | 5193141562 | 4 |
| Entity Name | Nrg-parkland Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902430481 PECOS PAC ID: 5193141562 Enrollment ID: O20200814002516 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth L Miller, MD Po Box 629, Smith Imaging Inc, Farmington, MO 63640 Ph: (573) 760-8075 | Kenneth L Miller, MD 1101 W Liberty, Parkland Health Center Dept Of Radiology, Farmington, MO 63640 Ph: (573) 760-8075 |
Kenneth D Smith, MD Radiology Medicare: Medicare Enrolled Practice Location: 1101 W Liberty, Parkland Health Center Dept Of Radiology, Farmington, MO 63640 Phone: 573-760-8075 Fax: 573-760-8358 | |
Troy Constant Avendanio, Radiology Medicare: Accepting Medicare Assignments Practice Location: 1101 W Liberty St, Dept. Of Radiology, Farmington, MO 63640 Phone: 573-760-8075 |