Miller, Jerry Allan
Miller, Jerry Allan is an individual health care provider with primary practice located at 1245 Augusta West Pkwy , Augusta GA 30909-1807. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Miller, Jerry Allan can be contacted via phone (706) 868-0389.Contact Information
Primary practice address
1245 Augusta West Pkwy
Augusta GA 30909-1807
Phone: (706) 868-0389
Fax: (706) 651-0729
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 018708 | Georgia |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 018708 | Georgia |
Profile Details
| NPI number | 1679534762 |
|---|---|
| LBN Legal business name | Miller, Jerry Allan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 29th, 2006 |
| Last updated | Mar 18th, 2016 - about 10 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 | 1679534762 | NPPES |
| Georgia | MEDICAID | 000199746C |
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