Provider Demographics
NPI:1497759138
Name:MILUM, JOSEPH A (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:MILUM
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:PO BOX 950245
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0245
Mailing Address - Country:US
Mailing Address - Phone:502-272-5100
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:9340 CEDAR CENTER WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-4522
Practice Address - Country:US
Practice Address - Phone:502-239-8431
Practice Address - Fax:502-239-8399
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY304092083P0011X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
072881OtherSIHO - NMA
KY090468OtherSIHO - NAWCC
7838630OtherCIGNA / NMA
KY3701993000OtherPASSPORT ADVANTAGE - NAWCC
50009783OtherPASSPORT - NMA
KYP00293243OtherRAILROAD MEDICARE
000000386705OtherANTHEM - NMA
000023025VOtherHUMANA / NMA
KY64304090Medicaid
000000482467OtherANTHEM - NICC
KY000000606001OtherANTHEM - NAWCC
2689193000OtherPASSPORT ADVANTAGE / NMA
50022969OtherPASSPORT - NAWCC
KY7838630OtherCIGNA - NAWCC
KY64304090Medicaid
KY7838630OtherCIGNA - NAWCC