Provider Demographics
NPI:1700271376
Name:MILES, JENNIFER R (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:R
Last Name:MILES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JENNY
Other - Middle Name:RENE
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5201 FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4501
Mailing Address - Country:US
Mailing Address - Phone:912-351-3030
Mailing Address - Fax:
Practice Address - Street 1:5201 FREDERICK ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4501
Practice Address - Country:US
Practice Address - Phone:912-351-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-31
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA85909207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty