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JACK W MILLER M.D NPI 1275699514


NPI Information

NPI: 1275699514
Provider Name: JACK W MILLER, M.D
Classification: Pediatrics - 2080P0006X
Entity Type: Individual

Specialization: Developmental - Behavioral Pediatrics

Address:
100 PROFESSIONAL PL
STE 104
CARROLLTON, GA
ZIP 30117
Phone: (770) 830-7039
Get Directions

Jack W Miller, M.D is a developmental - behavioral pediatrics pediatrics in Carrollton, GA. The provider is a developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. Jack W Miller, M.D NPI is 1275699514. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

100 PROFESSIONAL PL
STE 104
CARROLLTON, GA
ZIP 30117-874
Phone: (770) 830-7039
Fax: (770) 830-7149

The enumeration date for this NPI number is 12/29/2006 and was last updated on 8/6/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080P0006XPediatricsDevelopmental - Behavioral Pediatrics044541GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1E61074MEDICARE UPINGEORGIA
2000767709CMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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