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Individual

RICHARD JOHN MILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1850 CHADWICK DR, JACKSON, MS 39204-3404
(904) 805-1300
(904) 805-1302
Mailing address
PO BOX 75473, BALTIMORE, MD 21275-5473
(904) 805-1300
(904) 805-1302

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
19044
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09621896
MS
05
1323454
LA
01
202011213A
BLUE CROSS
MS
Enumeration date
06/08/2006
Last updated
07/25/2025
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