Provider Demographics
NPI:1679589006
Name:MILLER, JOHN WINSTON (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WINSTON
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3223 8TH ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1623
Mailing Address - Country:US
Mailing Address - Phone:504-833-7770
Mailing Address - Fax:504-833-7782
Practice Address - Street 1:352 HOSPIAL BOULEVARD
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71361-5352
Practice Address - Country:US
Practice Address - Phone:318-448-0811
Practice Address - Fax:318-473-6395
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12097R207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1694789Medicaid
LAG48180Medicare UPIN
LA5Y983Medicare ID - Type Unspecified