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Dr. James R Miller
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NPI Number Detailed Information
Provider Information:
| Name: | Dr. James R Miller |
| Gender: | M |
| Provider License Number If Given: | 01018808A |
NPI Information:
| NPI: | 1215936737 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/18/2005 |
| Last Update Date: | 6/20/2011 |
Provider Business Mailing Address:
| Address: | PO BOX 1887 Elkhart, IN 46515 |
| Phone Number: | 5743895042 |
| Fax Number: | 5745228505 |
Provider Business Practice Location Address:
| Address: | 1753 FULTON ST Elkhart, IN 46514 |
| Phone Number: | 5743899881 |
| Fax Number: | 5743899884 |
Provider Taxonomy:
| Primary: | 208D00000X |
| Secondary (if any): | |
| State: | IN |
