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Individual

JASON R. MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
3300 HIGH ST, SUITE 1, PORTSMOUTH, VA 23707-3321
(757) 397-0783
(757) 397-0236
Mailing address
PO BOX 7848, PORTSMOUTH, VA 23707-0848
(757) 397-0783
(757) 397-0236

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001952
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010239770
VA
01
P00193130
MEDICARE RR
VA
01
P00799175
RR MEDICARE
VA
Enumeration date
07/24/2006
Last updated
04/08/2010
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