Provider Demographics
NPI:1154480838
Name:MILLER, JAMES LINDSAY CROSS (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LINDSAY CROSS
Last Name:MILLER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:4802 DOE RUN
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-6204
Mailing Address - Country:US
Mailing Address - Phone:706-869-8073
Mailing Address - Fax:706-869-8073
Practice Address - Street 1:DDEAMC, GASTROENTEROLOGY CLINIC
Practice Address - Street 2:MCL, BLDG #300
Practice Address - City:FT. GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905
Practice Address - Country:US
Practice Address - Phone:706-787-8600
Practice Address - Fax:706-787-2409
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA01934363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA01934OtherLICENSE NUMBERE