Provider Demographics
NPI:1023016946
Name:MILLER, JAMES S (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1500 OGLETHORPE AVE
Mailing Address - Street 2:SUITE 600F
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2179
Mailing Address - Country:US
Mailing Address - Phone:706-475-4917
Mailing Address - Fax:706-475-4636
Practice Address - Street 1:1199 PRINCE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2797
Practice Address - Country:US
Practice Address - Phone:706-475-1700
Practice Address - Fax:706-546-1787
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015401207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000116223LMedicaid
GA1265576OtherUNITED HEALTHCARE
GA000116223HMedicaid
GA00721OtherBLUE SHIELD
GA00116223AMedicaid
GA060014201OtherRAILRAOD MEDICARE
GA000116223FMedicaid
GA000116223GMedicaid
GA000116223IMedicaid
GA000116223KMedicaid
GA000116223JMedicaid
GA5246017OtherAETNA
GA000116223LMedicaid
GA000116223JMedicaid