Provider Demographics
NPI:1629782230
Name:MILES, JAMES (PRSS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MILES
Suffix:
Gender:M
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10463 E OSBORN RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85256-4021
Mailing Address - Country:US
Mailing Address - Phone:623-283-0713
Mailing Address - Fax:
Practice Address - Street 1:6239 E BROWN RD BLDG 1
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-4933
Practice Address - Country:US
Practice Address - Phone:623-283-0713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist