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Individual
DR. JON MILLER
Active
Individual
DR. JON MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9568
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000008287
MEDICARE PART B GRP ID#
MT
01
—
0000095270
BCBS ER PHYS GROUP
MT
01
—
0000095390
NVH-OB PHYS GROUP
MT
01
—
000091751
BLUE CROSS/SHIELD PIN
—
05
—
0027098
—
MT
05
—
0033660
—
MT
05
—
00355628
—
MT
01
—
080161691
RAILROAD MEDICARE PIN#
MT
01
—
1104882232
GLACIER MEDICAL ASSOC NPI
MT
01
—
27D0411341
CLIA ID#--LAB CERT
MT
01
—
810350909
FEIN
MT
01
—
9568
MONTANA STATE LICENSE
MT
01
—
CI2709
RAILROAD MEDICARE GRP ID#
MT
Enumeration date
03/07/2006
Last updated
05/12/2008
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