Provider Demographics
NPI:1679534523
Name:MILLER, JANE C (MD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:C
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:L
Other - Last Name:CAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4740 S I 10 SERVICE RD W
Mailing Address - Street 2:STE 340
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-1234
Mailing Address - Country:US
Mailing Address - Phone:504-455-0004
Mailing Address - Fax:504-455-0097
Practice Address - Street 1:4740 SI- 10 SERVICE RD
Practice Address - Street 2:STE 340
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001
Practice Address - Country:US
Practice Address - Phone:504-455-0004
Practice Address - Fax:504-455-0097
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015455207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1329347Medicaid
50334Medicare ID - Type Unspecified
LA1329347Medicaid
B62328Medicare UPIN