Individual
JUD E MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
SHC 100, BRIGHAM YOUNG UNIVERSITY IDAHO, REXBURG, ID 83460-2010
(208) 496-1300
(208) 496-1306
Mailing address
SHC 100, BRIGHAM YOUNG UNIVERSITY IDAHO, REXBURG, ID 83460-0001
(208) 496-1300
(208) 496-1306
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4189
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012050
—
ID
Enumeration date
12/16/2005
Last updated
07/08/2007
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