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Individual

DR. JACOB BENJAMIN MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 NE SAINT LUKES BLVD, LEES SUMMIT, MO 64086-6000
(816) 347-5097
(816) 347-5045
Mailing address
PO BOX 412431, KANSAS CITY, MO 64141-2431
(913) 647-4100
(913) 258-2509

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2011012600
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1881808061
MO
05
207086307
MO
01
46511019
BCBS KC
MO
01
P01085334
RAILROAD
MO
Enumeration date
05/09/2007
Last updated
01/29/2021
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