Miller, Mark

Miller, Mark is an sole proprietor health care provider with primary practice located at 450 S Camino Del Rio Suite 101, Durango CO 81301-6856. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Miller, Mark can be contacted via phone (970) 247-3613.

Contact Information

Primary practice address
450 S Camino Del Rio Suite 101 Durango CO 81301-6856
Fax: (970) 247-5823
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT1837 Colorado

Profile Details

NPI number 1255528873
LBN Legal business name Miller, Mark
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 27th, 2007
Last updated Sep 27th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255528873 NPPES
Colorado MEDICAID 08918377

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