Provider Demographics
NPI:1316076821
Name:MILLER, JOEL E (DO)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:E
Last Name:MILLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:535 YAMPA AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-2627
Mailing Address - Country:US
Mailing Address - Phone:970-824-6530
Mailing Address - Fax:970-826-0915
Practice Address - Street 1:535 YAMPA AVE
Practice Address - Street 2:STE 300
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2627
Practice Address - Country:US
Practice Address - Phone:970-824-6530
Practice Address - Fax:970-826-0915
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO33778207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01337781Medicaid
COE92359Medicare UPIN
CO01337781Medicaid