Individual
DR. JACOB RYAN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DIV SURG CT PEDS, STE 2A, SAINT LOUIS, MO 63110-1002
(314) 454-6165
(314) 454-2381
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-6165
(314) 454-2381
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
2013021966
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200007975
—
MO
Enumeration date
06/20/2011
Last updated
05/28/2025
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