Provider Demographics
NPI:1043487200
Name:DODXRX
Entity Type:Organization
Organization Name:DODXRX
Other - Org Name:HIGH COUNTRY MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:970-824-6530
Mailing Address - Street 1:535 YAMPA AVE
Mailing Address - Street 2:SUITE 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:SUITE 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33778207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty