Provider Demographics
NPI:1104054279
Name:JILL C. MILLER, DO, PC
Entity type:Organization
Organization Name:JILL C. MILLER, DO, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:814-763-2010
Mailing Address - Street 1:700 ERIE ST
Mailing Address - Street 2:
Mailing Address - City:SAEGERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:16433-5004
Mailing Address - Country:US
Mailing Address - Phone:814-763-2010
Mailing Address - Fax:814-763-5535
Practice Address - Street 1:700 ERIE ST
Practice Address - Street 2:
Practice Address - City:SAEGERTOWN
Practice Address - State:PA
Practice Address - Zip Code:16433-5004
Practice Address - Country:US
Practice Address - Phone:814-763-2010
Practice Address - Fax:814-763-5535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014250207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty