Provider Demographics
NPI:1295900660
Name:MIGLIORE, JOSEPH JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JAMES
Last Name:MIGLIORE
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 1:6178 HIGHWAY 238
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97530-9127
Mailing Address - Country:US
Mailing Address - Phone:603-540-9124
Mailing Address - Fax:
Practice Address - Street 1:6178 HIGHWAY 238
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97530-9127
Practice Address - Country:US
Practice Address - Phone:603-540-9124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 016767 E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C 29764Medicare UPIN