| Doctor Name: | BRIAN DAVID MILLER |
| NPI Number: | 1861483455 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C BS |
| License Number: | PA-309 |
| Business Practice Address: | 167 E 1st S Rigby, ID - 834421401 |
| Business Phone Number: | 2087458747 |
| Business Fax Number: | 2087459396 |
| Mailing Address: | 167 E 1st S, RIGBY |
| State: | ID |
| Postal Code: | 834421401 |
| Phone Number: | 2087458747 |
| Fax Number: | |
| NPI Enumeration Date: | 11/02/2005 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA-309 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |