Provider Demographics
NPI:1073533196
Name:MILLER, JULE P III (MD)
Entity Type:Individual
Prefix:
First Name:JULE
Middle Name:P
Last Name:MILLER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:983 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39530-3756
Mailing Address - Country:US
Mailing Address - Phone:228-435-4400
Mailing Address - Fax:228-435-4400
Practice Address - Street 1:983 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-3756
Practice Address - Country:US
Practice Address - Phone:228-435-4400
Practice Address - Fax:228-435-4400
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS134922084P0800X, 2084P0804X
MO368062084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00236002Medicaid