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:
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Health care specialties

SpecialtyCodeLicense #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 9 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 1679534762 NPPES
Georgia MEDICAID 000199746C

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