Provider Demographics
NPI:1013995042
Name:MILLER, JAMES ANDREW (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ANDREW
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 E MAIN ST
Mailing Address - Street 2:PO BOX 8674
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56002-8674
Mailing Address - Country:US
Mailing Address - Phone:507-625-1811
Mailing Address - Fax:
Practice Address - Street 1:1575 LOOKOUT DR
Practice Address - Street 2:
Practice Address - City:NORTH MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56003-2503
Practice Address - Country:US
Practice Address - Phone:507-625-5027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN40074207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
41084933956001C135OtherCHAMPUS
MNHP29064OtherHEALTH PARTNERS
MN0104105OtherMEDICA
MNNA2951023849OtherPREFERRED ONE
MN0121056OtherMEDICA
MN914211OtherAMERICAS PPO
MN985518100Medicaid
MN123693OtherUCARE
080149994OtherRR MEDICARE
MN41B85MIOtherBCBS
MN0121056OtherMEDICA
MN123693OtherUCARE