Provider Demographics
NPI:1225042740
Name:MILLER, JAMES O (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:O
Last Name:MILLER
Suffix:
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 1:1210 BRIARVILLE RD
Mailing Address - Street 2:BLDG. A
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-5141
Mailing Address - Country:US
Mailing Address - Phone:615-868-4682
Mailing Address - Fax:615-868-5242
Practice Address - Street 1:1210 BRIARVILLE RD
Practice Address - Street 2:BLDG. A
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5141
Practice Address - Country:US
Practice Address - Phone:615-868-4682
Practice Address - Fax:615-868-5242
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD7261207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B02760Medicare ID - Type Unspecified
TN3159154Medicare ID - Type Unspecified