Provider Demographics
NPI:1366508830
Name:MILLER, JEFFREY ROBERT (MD, MPH)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ROBERT
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 DEER LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-1716
Mailing Address - Country:US
Mailing Address - Phone:347-693-1023
Mailing Address - Fax:
Practice Address - Street 1:625 FORSTER ST
Practice Address - Street 2:HEALTH & WELFARE BUILDING, ROOM 933
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17120-0701
Practice Address - Country:US
Practice Address - Phone:717-787-3350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432284207R00000X, 208000000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine