Individual
DR. JASON R MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
910 ADAMS ST SE STE 215, HUNTSVILLE, AL 35801-3759
(256) 265-4950
(256) 265-4949
Mailing address
910 ADAMS ST SE STE 215, HUNTSVILLE, AL 35801-3759
(256) 265-4950
(256) 265-4949
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
05054
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009996805
—
AL
05
—
009996815
—
AL
05
—
009996825
—
AL
05
—
009996835
—
AL
01
—
051528747
BLUE CROSS
AL
01
—
051528751
BLUE CROSS
AL
01
—
051528752
BLUE CROSS
AL
01
—
051528754
BLUE CROSS
AL
01
—
102G700181
MEDICARE GROUP PTAN
AL
01
—
102I850178
MEDICARE PTAN
AL
05
—
129559
—
AL
05
—
129563
—
AL
01
—
51117227
BCBS
AL
Enumeration date
03/10/2006
Last updated
12/22/2011
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