Miller, Jerry J
Miller, Jerry J is an individual health care provider with primary practice located at 111 Wisconsin American Dr , Fond Du Lac WI 54937-6725. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Miller, Jerry J can be contacted via phone (920) 923-0788.Contact Information
Primary practice address
111 Wisconsin American Dr
Fond Du Lac WI 54937-6725
Phone: (920) 923-0788
Fax: (920) 273-0085
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 30596 | Wisconsin |
Profile Details
| NPI number | 1497758049 |
|---|---|
| LBN Legal business name | Miller, Jerry J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2005 |
| Last updated | Dec 9th, 2020 - about 4 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 | 1497758049 | NPPES |
| Wisconsin | MEDICAID | 1497758049 |
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