Individual
JEAN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1265 CLIFF GOOKIN BLVD, TUPELO, MS 38801-6749
(662) 840-2131
(662) 840-2522
Mailing address
1265 CLIFF GOOKIN BLVD, TUPELO, MS 38801-6749
(662) 840-2131
(662) 840-2522
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11014874A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000912821
BCBS
IN
05
—
201068970
—
IN
Enumeration date
06/11/2009
Last updated
03/11/2025
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