Provider Demographics
NPI:1538172838
Name:MILLER, JAMES STEWART (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STEWART
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4541 N DAVIS HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2783
Mailing Address - Country:US
Mailing Address - Phone:850-477-6190
Mailing Address - Fax:
Practice Address - Street 1:4541 N DAVIS HWY
Practice Address - Street 2:SUITE B
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2783
Practice Address - Country:US
Practice Address - Phone:850-477-6190
Practice Address - Fax:850-479-8489
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22150207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL406071306OtherRRB PTAN
FL17314Medicare UPIN
FLD61964Medicare PIN