Provider Demographics
NPI:1144221292
Name:MILLER, AMY L (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-207-3060
Mailing Address - Fax:504-207-3067
Practice Address - Street 1:1315 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2406
Practice Address - Country:US
Practice Address - Phone:504-842-3900
Practice Address - Fax:504-842-0011
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10642R2080A0000X
LAMD.10642R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01853361Medicaid
LA1993654Medicaid
MS01853361Medicaid