Healthcare Provider Details

I. General information

NPI: 1063456465
Provider Name (Legal Business Name): JOSEPH S MILLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 HARLAN DR
BELLEVUE NE
68005-6602
US

IV. Provider business mailing address

1902 HARLAN DR
BELLEVUE NE
68005-6602
US

V. Phone/Fax

Practice location:
  • Phone: 402-682-4165
  • Fax: 402-934-2291
Mailing address:
  • Phone: 402-682-4165
  • Fax: 402-934-2291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD-48000
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number16501
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number16501
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: