Individual
JILL DANA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1510 HUDSON BRIDGE RD, STOCKBRIDGE, GA 30281-5020
(404) 785-8660
(404) 785-8730
Mailing address
1510 HUDSON BRIDGE RD, STOCKBRIDGE, GA 30281-5020
(404) 785-8660
(404) 785-8730
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101234592
VA
208000000X
Pediatrics Physician
0101234592
VA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
0101234592
VA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
89760
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006739580
—
VA
05
—
1008314420001
—
PA
05
—
403588700
—
MD
05
—
89066FT
—
NC
Enumeration date
06/06/2006
Last updated
02/25/2022
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