Provider Demographics
NPI:1629047022
Name:ARIZONA ACUTE NEUROLOGIC CLINIC PC
Entity Type:Organization
Organization Name:ARIZONA ACUTE NEUROLOGIC CLINIC PC
Other - Org Name:JESS A. MILLER MD PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JESS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-860-2455
Mailing Address - Street 1:10900 N SCOTTSDALE RD
Mailing Address - Street 2:STE 303
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5216
Mailing Address - Country:US
Mailing Address - Phone:480-860-2455
Mailing Address - Fax:480-767-5574
Practice Address - Street 1:10900 N SCOTTSDALE RD
Practice Address - Street 2:STE 303
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5216
Practice Address - Country:US
Practice Address - Phone:480-860-2455
Practice Address - Fax:480-767-5574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ23324Medicare ID - Type Unspecified