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Brian David Miller, PA-CBS
Medical Physician Assistant in Idaho Falls, Idaho
NPI 1861483455

Brian David Miller is a Medical Physician Assistant based in Idaho Falls, ID and is specialized in Medical. Brian David Miller practices in Idaho Falls, ID and has the professional credentials of PA-CBS. The NPI Number for Brian David Miller is 1861483455 and holds a License No. PA-309 (Idaho).

The current practice location address for Brian David Miller is 2680 Channing Way, Idaho Falls, ID and can be reached out via phone at 208-523-7667 and via fax at 208-523-7668.

Location: 2680 Channing Way, Idaho Falls, ID, 83404-7517
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Provider Profile Details
NPI Number
1861483455
Provider Name
Brian David Miller
Credential
PA-CBS
Provider Entity Type
Individual
Gender
Male
Address
2680 Channing Way, Idaho Falls, ID, 83404-7517
Phone Number
208-523-7667
Fax Number
208-523-7668
Provider Enumeration Date
11/02/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1041907 01 PACIFIC SOURCE
8059104-00 05 ID
PA-309 01 ID ID STATE LISC
institution
Provider Business Practice Location Address Details
Address
2680 Channing Way
City
State
Zip
83404-7517
Phone Number
208-523-7667
Fax Number
208-523-7668
person
Provider Business Mailing Address Details
Address
2680 Channing Way
City
State
Zip
83404-7517
Phone Number
208-523-7667
Fax Number
208-523-7668
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA-309 (Idaho)
Definition
Definition to come...
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