Mark D Miller, PA-C
Individual provider Active NPI Physician Assistant · Winchester, KS
NPI 1154425544 · NPPES record last updated May 1, 2009
Key facts
- NPI
- 1154425544
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 15-00682 (KS)
- Practice address
- 408 Delaware St
Winchester, KS 66097-4003 - Phone
- (913) 774-4340
- Fax
- (913) 774-3329
- NPI assigned
- Sep 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15-00682 | KS | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Arts Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 15-00682 | KS | Yes |
Addresses
Primary practice location
408 Delaware St
Winchester, KS 66097-4003
Mailing address
408 Delaware St
Winchester, KS 66097-4003
Phone (913) 774-4340
Other providers in Winchester, KS
- Jefferson County Memorial Hospital, Inc.
- Jefferson County Memorial Hospital, Inc.
- Jefferson County North Usd339
- Michael F Law
- Geraldine Loween Long
- Cristin Noll
- Alexander Overbey
- James V Rider
- Shelby Sprang
- Cathryn Wieck
All providers in Winchester, KS · Physician Assistant in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.