Healthcare Provider Details

I. General information

NPI: 1871586131
Provider Name (Legal Business Name): HAROLD J MILLER MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15770 PAUL VEGA MD DR SUITE 202
HAMMOND LA
70403-1475
US

IV. Provider business mailing address

15770 PAUL VEGA MD DR SUITE 202
HAMMOND LA
70403-1475
US

V. Phone/Fax

Practice location:
  • Phone: 985-429-8168
  • Fax: 985-429-8712
Mailing address:
  • Phone: 985-429-8168
  • Fax: 985-429-8712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number09306R
License Number StateLA

VIII. Authorized Official

Name: DR. HAROLD JOSEPH MILLER JR.
Title or Position: OWNER
Credential: MD
Phone: 985-429-8168