Individual
JANICE L MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3418 MAIN ST, MOSS POINT, MS 39563-5102
(228) 474-6111
(361) 576-4219
Mailing address
PO BOX 3590, VICTORIA, TX 77903-3590
(228) 474-6111
(361) 576-4219
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
DO16488
MS
207RP1001X
Pulmonary Disease Physician
Primary
DO16488
MS
207RS0012X
Sleep Medicine (Internal Medicine) Physician
DO16488
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121255
—
MS
01
—
640934949
TAX ID #
—
Enumeration date
12/08/2005
Last updated
11/18/2010
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