| Russell Miller Md Family Practice Pc | |
|
121 Beech Avenue Patton PA 16668-1017 | |
| (814) 674-5225 | |
| (814) 674-2338 |
| Full Name | Russell Miller Md Family Practice Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 121 Beech Avenue, Patton, Pennsylvania |
| Authorized Official Name and Position | Russell Paul Miller (PRESIDENT) |
| Authorized Official Contact | 8146745225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Russell Miller Md Family Practice Pc 121 Beech Avenue Patton PA 16668-1017 Ph: (814) 674-5225 | Russell Miller Md Family Practice Pc 121 Beech Avenue Patton PA 16668-1017 Ph: (814) 674-5225 |
| NPI Number | 1932390895 |
|---|---|
| Provider Enumeration Date | 08/06/2007 |
| Last Update Date | 08/06/2007 |
| Medicare PECOS PAC ID | 5193775435 |
|---|---|
| Medicare Enrollment ID | O20050125000698 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932390895 | NPI | - | NPPES |
| 0016115020008 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Russell P Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174522270 PECOS PAC ID: 0042260309 Enrollment ID: I20101025000908 |
Conemaugh Health Initiatives Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 503 Railroad Ave, Suite 4, Patton, PA 16668 Phone: 814-674-6050 Fax: 814-674-6053 |