Gordon a Miller MD PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

MD11962 Issued in OR

Legal business name

GORDON A MILLER MD PC

Practice address

2001 Commercial St SE
Salem, OR 97302-5207

Phone

(503) 363-1500

Fax

(503) 588-2028

NPI assigned

Sep 21, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gordon A Miller, MD

Title

Owner

Phone

(503) 363-1500

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Willamette Valley EyeCenter Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keith M Irwin, MA, QMHP

  • Counselor
  • Salem, OR
  • NPI 1932345139
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1235325473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025207",
            "telephone_number": "503-363-1500",
            "fax_number": "503-588-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025207",
            "telephone_number": "503-363-1500",
            "fax_number": "503-588-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON A MILLER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-363-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "MD11962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "756183994",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006291",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willamette Valley EyeCenter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dana Goodale, MSW, QMHA
• Michael E Goodenberger, MD
• Lora Wilson Goodenough, LMFT
• Dianna Lynn Goolsby, RN
• Raylene Lorraine Gordin, M.D.
• Gordon a Miller, MD
• Corrie Lynn Gordon, LCSW
• Jamila Enirisha Gordon
• Jerome S Gordon, PH.D.
• Matthew S Gordon, M.D.

• Clinic/Center in Salem, OR
• Providers in Salem, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.