Provider Demographics
NPI:1174102024
Name:MILLER, MICHAEL MINTON (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MINTON
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 FOUNTAIN COURT
Mailing Address - Street 2:SUITE 215
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:859-323-1670
Practice Address - Street 1:245 FOUNTAIN COURT
Practice Address - Street 2:SUITE 215
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1810
Practice Address - Country:US
Practice Address - Phone:859-323-6021
Practice Address - Fax:859-323-4927
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR60022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry