Provider Demographics
NPI:1760455729
Name:MILLER, STEVEN P (OD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:P
Last Name:MILLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 N WEBB RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3413
Mailing Address - Country:US
Mailing Address - Phone:316-858-3831
Mailing Address - Fax:316-858-3830
Practice Address - Street 1:2701 N MAIN
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-3479
Practice Address - Country:US
Practice Address - Phone:620-663-8700
Practice Address - Fax:620-663-8713
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1720152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200387810AMedicaid
KSV07182Medicare UPIN
KS065124Medicare ID - Type Unspecified
KS200387810AMedicaid