Provider Demographics
NPI:1578206769
Name:MILLER, MATTHEW JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JAMES
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1300 OLD WEISGARBER RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1291
Mailing Address - Country:US
Mailing Address - Phone:865-584-2146
Mailing Address - Fax:865-374-2103
Practice Address - Street 1:1300 OLD WEISGARBER RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1291
Practice Address - Country:US
Practice Address - Phone:865-584-2146
Practice Address - Fax:865-374-2103
Is Sole Proprietor?:No
Enumeration Date:2022-04-15
Last Update Date:2025-09-02
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Provider Licenses
StateLicense IDTaxonomies
ALL.5755R207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ104844Medicaid