Provider Demographics
NPI:1891859120
Name:MILLER, JAMES D (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 750668
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45475-0668
Mailing Address - Country:US
Mailing Address - Phone:937-439-9330
Mailing Address - Fax:937-439-9337
Practice Address - Street 1:7810 MCEWEN RD
Practice Address - Street 2:SUITE A
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4077
Practice Address - Country:US
Practice Address - Phone:937-439-9330
Practice Address - Fax:937-439-9337
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0284928Medicaid
T78480Medicare UPIN
OH0411543Medicare PIN