Miller, Jack Edwin
Miller, Jack Edwin is an individual health care provider with primary practice located at 765 Baywood Dr #231, Petaluma CA 94954. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Miller, Jack Edwin can be contacted via phone (707) 762-2166.Contact Information
Primary practice address
765 Baywood Dr #231
Petaluma CA 94954
Phone: (707) 762-2166
Fax: (707) 766-8160
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | G26214 | California |
Profile Details
| NPI number | 1497824627 |
|---|---|
| LBN Legal business name | Miller, Jack Edwin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 6th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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