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General NPI Number Information
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NPI Number | 1407075302
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Entity Type | Organization
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Legal Business Name | J L MILES, DO SLEEP LAB
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3418 MAIN ST
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City | MOSS POINT
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State | MS
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Zip | 39563-5102
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Country | US
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Telephone | 228-474-6111
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Fax | 361-576-4219
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Provider Business Mailing Address
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Address Line | PO BOX 3590
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City | VICTORIA
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State | TX
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Zip | 77903-3590
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Country | US
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Telephone | 361-576-3680
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Fax | 361-576-4219
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Authorized Official
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Title or Position | OWNER
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Name | DR. JANICE L MILES
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Credential | D.O.
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Telephone | 228-474-6111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 16488
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License Number State | TX
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