Richard Allan Miller, OD
Individual provider Active NPI Optometrist · Plain City, OH
NPI 1821038050 · NPPES record last updated Sep 26, 2008
Key facts
- NPI
- 1821038050
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 4217/T949 (OH)
- Practice address
- 302 W Main St
Suite 100
Plain City, OH 43064-4140 - Phone
- (614) 873-1003
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4217 | OH | MD | Chiropractor |
| 4217/T949 | OH | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarkson Optometry Midwest Inc | Optometrist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4217/T949 | OH | Yes |
Addresses
Primary practice location
302 W Main St
Suite 100
Plain City, OH 43064-4140
Mailing address
302 W Main St
Suite 100
Plain City, OH 43064-4140
Phone (614) 873-1003
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300028432 | Other | OH | TRICARE |
| 000000224728 | Other | OH | ANTHEM |
| 2200301 | Other | OH | UNITED HEALTHCARE |
| 5452035 | Other | OH | AETNA |
| P00142870 | Other | OH | RAILROAD MEDICARE |
| 0862204 | Medicaid | OH |
Other providers in Plain City, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2008. 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.