Provider Demographics
NPI:1558548941
Name:MILLER, JOSEPH R JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:MILLER
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CAMBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-3763
Mailing Address - Country:US
Mailing Address - Phone:641-682-8530
Mailing Address - Fax:
Practice Address - Street 1:1025 N QUINCY AVE STE 2
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-3874
Practice Address - Country:US
Practice Address - Phone:641-683-4483
Practice Address - Fax:641-682-2718
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist