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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1053353045 NPPES
Missouri MEDICAID 246870067

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