Provider Demographics
NPI:1447330600
Name:MILLER, LINDA L (OD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11656 PLAZA AMERICA DR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-4700
Mailing Address - Country:US
Mailing Address - Phone:703-467-0359
Mailing Address - Fax:703-467-9080
Practice Address - Street 1:7263E ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3219
Practice Address - Country:US
Practice Address - Phone:703-573-1200
Practice Address - Fax:703-573-1250
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618 000327152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9231676Medicaid
VA277481OtherALLIANCE,MDIPA,MAMSI,OPC
VA452090OtherANTHEM-ALEX
VA452088OtherANTHEM-LP
VA2069104OtherAETNA HMO
VA5534007OtherAETNA PPO
VA9314-0004OtherBCBS
VA9314-0004OtherBCBS
VAU64967Medicare UPIN