| Doctor Name: | DR. KELLAN ROBERT MILLER |
| NPI Number: | 1093941775 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 52743 |
| Business Practice Address: | 3655 E 104th Ave Thornton, CO - 802334469 |
| Business Phone Number: | 3032548500 |
| Business Fax Number: | 3034531819 |
| Mailing Address: | 3655 E 104th Ave, THORNTON |
| State: | CO |
| Postal Code: | 802334469 |
| Phone Number: | 3032548500 |
| Fax Number: | 3034531819 |
| NPI Enumeration Date: | 06/08/2009 |
| NPI Last Update Date: | 09/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 52743 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |