Healthcare Provider Details

I. General information

NPI: 1396742508
Provider Name (Legal Business Name): CHRISTOPHER MILLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: C BRIAN MILLER M.D.

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15813 PAUL VEGA MD DR STE 201
HAMMOND LA
70403-1431
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 985-230-7440
  • Fax: 985-230-7441
Mailing address:
  • Phone: 225-526-0001
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number12706R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: