Provider Demographics
NPI:1528048923
Name:MILLER, JEFFREY JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JAMES
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:501-609-2368
Mailing Address - Fax:501-609-2248
Practice Address - Street 1:ONE MERCY LANE
Practice Address - Street 2:SUITE 106
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6408
Practice Address - Country:US
Practice Address - Phone:501-609-2368
Practice Address - Fax:501-609-2248
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2865207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR142925001Medicaid
AR142925001Medicaid
AR142925001Medicaid
ARG79667Medicare UPIN