Basic Information
| Provider Information | |||||||||
| NPI: | 1023016946 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 OGLETHORPE AVE | ||||||||
| Address2: | SUITE 600F | ||||||||
| City: | ATHENS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 306062179 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7064754917 | ||||||||
| FaxNumber: | 7064754636 | ||||||||
| Practice Location | |||||||||
| Address1: | 1199 PRINCE AVE | ||||||||
| Address2: | |||||||||
| City: | ATHENS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 306062797 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7064751700 | ||||||||
| FaxNumber: | 7065461787 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2005 | ||||||||
| LastUpdateDate: | 04/02/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 015401 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 000116223L | 05 | GA | MEDICAID | 1265576 | 01 | GA | UNITED HEALTHCARE | OTHER | 000116223H | 05 | GA | MEDICAID | 00721 | 01 | GA | BLUE SHIELD | OTHER | 00116223A | 05 | GA | MEDICAID | 060014201 | 01 | GA | RAILRAOD MEDICARE | OTHER | 000116223F | 05 | GA | MEDICAID | 000116223G | 05 | GA | MEDICAID | 000116223I | 05 | GA | MEDICAID | 000116223K | 05 | GA | MEDICAID | 000116223J | 05 | GA | MEDICAID | 5246017 | 01 | GA | AETNA | OTHER |