Doctor Name: | MR. SANFORD EUGENE MILLER |
NPI Number: | 1568550200 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ATC/LAT |
License Number: | 625 |
Business Practice Address: | Homer Bryce Stadium/athletic Field House Nacogdoches, TX - 759620001 |
Business Phone Number: | 9364684550 |
Business Fax Number: | 9364684052 |
Mailing Address: | 4606 Ridgebrook Dr, NACOGDOCHES |
State: | TX |
Postal Code: | 759652152 |
Phone Number: | 9365601447 |
Fax Number: | 9364684052 |
NPI Enumeration Date: | 10/10/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 625 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |