Provider Demographics
NPI:1053533406
Name:MILLER, RICHARD ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ERIC
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4701 LAKELAND DR
Mailing Address - Street 2:APT 28-C
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9506
Mailing Address - Country:US
Mailing Address - Phone:601-405-1593
Mailing Address - Fax:601-984-5675
Practice Address - Street 1:513-C BROOKMAN DR
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-2399
Practice Address - Country:US
Practice Address - Phone:601-833-3822
Practice Address - Fax:601-835-4330
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS18980207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology