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General NPI Number Information
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NPI Number | 1073512125
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Entity Type | Individual
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Provider Name | SCOTT THOMAS MILES MD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 8262 POINT MEADOWS DR STE 201
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City | JACKSONVILLE
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State | FL
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Zip | 32256-4702
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Country | US
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Telephone | 904-288-8311
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Fax | 904-288-8371
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Provider Business Mailing Address
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Address Line | 705 WELLS RD STE 300
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City | ORANGE PARK
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State | FL
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Zip | 32073-2982
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Country | US
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Telephone | 904-288-8311
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Fax | 904-288-8371
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 74308
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 01034481A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 74308
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 01034481A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | ME125620
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | ME125620
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License Number State | FL
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