Healthcare Provider Details

I. General information

NPI: 1114143765
Provider Name (Legal Business Name): JOHN E MILLER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1949 GUNBARREL RD SUITE 150
CHATTANOOGA TN
37421-3188
US

IV. Provider business mailing address

1949 GUNBARREL RD SUITE 150
CHATTANOOGA TN
37421-3188
US

V. Phone/Fax

Practice location:
  • Phone: 423-296-0022
  • Fax: 423-296-0025
Mailing address:
  • Phone: 423-296-0022
  • Fax: 423-296-0025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMDO20155
License Number StateTN

VIII. Authorized Official

Name: DR. JOHN EDWIN MILLER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 423-296-0022