Individual
GORDON CHASON MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1506 E EVANS ST, BAINBRIDGE, GA 39819-4364
(229) 243-0740
(229) 243-7384
Mailing address
1506 E EVANS ST, BAINBRIDGE, GA 39819-4364
(229) 243-0740
(229) 243-7384
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
9888
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000012757A
—
GA
05
—
055001894A
—
GA
01
—
063603652
RAILROAD MEDICARE
GA
01
—
235747
BLUE CROSS BLUE SHIELD
GA
Enumeration date
05/19/2006
Last updated
02/07/2008
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