Provider Demographics
NPI:1770551459
Name:MILLER, JOSEPH DOUGLAS (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DOUGLAS
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 WELBY WAY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4462
Mailing Address - Country:US
Mailing Address - Phone:850-580-5252
Mailing Address - Fax:850-878-8400
Practice Address - Street 1:1931 WELBY WAY
Practice Address - Street 2:SUITE 1
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4462
Practice Address - Country:US
Practice Address - Phone:850-580-5252
Practice Address - Fax:850-878-8400
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8840111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8747274OtherUNITED HEALTH CARE
FL88774OtherBLUECROSSBLUESHIELD
FL88774AOtherBLUE CROSS/BS
FL381976100Medicaid
FL667374OtherACN
FLV03398Medicare UPIN
FL667374OtherACN