Individual
JERRY PAUL MILLER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 HOSPITAL DR, COLUMBIA, MO 65201-5275
(573) 814-6000
Mailing address
4701 CEDAR COALS CT # A, COLUMBIA, MO 65203-9072
(985) 515-4779
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
304573
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2012
Last updated
04/18/2022
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