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General NPI Number Information
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NPI Number | 1619105871
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Entity Type | Individual
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Provider Name | JACOB DANIEL MILLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/26/2009
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Last Update Date | 01/15/2020
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Provider Practice Location Address
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Address Line | 3000 ARLINGTON AVE
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City | TOLEDO
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State | OH
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Zip | 43614-2595
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Country | US
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Telephone | 419-383-3761
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Fax | 419-383-6255
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Provider Business Mailing Address
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Address Line | 4510 DORR ST # MS 840
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City | TOLEDO
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State | OH
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Zip | 43615-4040
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Country | US
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Telephone | 419-383-3761
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Fax | 419-383-6255
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 35.129589
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License Number State | OH
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