Individual
SUE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
708 W FOREST AVE, JACKSON, TN 38301-3901
(731) 660-8759
Mailing address
1804 HIGHWAY 45 BYP, STE 604, JACKSON, TN 38305-4436
(731) 660-8759
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34000
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3833050
—
TN
05
—
3862960
—
TN
01
—
4079286
BCBS
—
01
—
4105359
BCBS
—
Enumeration date
07/12/2006
Last updated
07/16/2009
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