Provider Demographics
NPI:1023016904
Name:MILLER, JOHN FRANKLIN (M D)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANKLIN
Last Name:MILLER
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 INDEPENDENCE PT
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4545
Mailing Address - Country:US
Mailing Address - Phone:864-797-6044
Mailing Address - Fax:
Practice Address - Street 1:11082 N RADIO STATION RD
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-1142
Practice Address - Country:US
Practice Address - Phone:864-882-2314
Practice Address - Fax:864-882-3677
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9351207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC080028017OtherRAILROAD MEDICARE
SCGP4697Medicaid
SC093516Medicaid
SCD993381259Medicare ID - Type Unspecified
SC8768Medicare PIN
SCD99338Medicare UPIN