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Organization

DAVID S. MILLER, MD, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID S. MILLER M.D. (OWNER)
(601) 366-6606
Entity
Organization

Contact information

Practice address
971 LAKELAND DR, SUITE 1252, JACKSON, MS 39216-4643
(601) 366-6606
(601) 366-6647
Mailing address
971 LAKELAND DR, SUITE 1252, JACKSON, MS 39216-4643
(601) 366-6606
(601) 366-6647

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
15802
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05650361
MS
01
CG1380
RR MEDICARE
MS
Enumeration date
08/16/2006
Last updated
04/28/2008
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