Miller, Jackie S
Miller, Jackie S is an sole proprietor health care provider with primary practice located at 1607 E Us Highway 136 , Albany MO 64402-8223. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Miller, Jackie S can be contacted via phone (660) 726-3311.Contact Information
Primary practice address
1607 E Us Highway 136
Albany MO 64402-8223
Phone: (660) 726-3311
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 104860 | Missouri |
Profile Details
| NPI number | 1053353045 |
|---|---|
| LBN Legal business name | Miller, Jackie S |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Dec 7th, 2017 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053353045 | NPPES |
| Missouri | MEDICAID | 246870067 |
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