Provider Demographics
NPI:1477635613
Name:MILLER, JAMES (OD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4056 MILNERS CRES
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7303
Mailing Address - Country:US
Mailing Address - Phone:256-369-2838
Mailing Address - Fax:256-406-0775
Practice Address - Street 1:6 N ELM AVE
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2426
Practice Address - Country:US
Practice Address - Phone:205-636-9283
Practice Address - Fax:256-405-0775
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS800TA312152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL10105227Medicaid
AL10105227Medicaid