MEDICARE: DR. SCOTT THOMAS MILES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083A0300X	Addiction Medicine (Preventive Medicine) Physician	74308	GA
2	2083A0300X	Addiction Medicine (Preventive Medicine) Physician	01034481A	IN
3	207QA0401X	Addiction Medicine (Family Medicine) Physician	74308	GA
4	207QA0401X	Addiction Medicine (Family Medicine) Physician	01034481A	IN
5	207QA0401X	Addiction Medicine (Family Medicine) Physician	ME125620	FL
6	2083A0300X	Addiction Medicine (Preventive Medicine) Physician	ME125620	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073512125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT THOMAS MILES MD

Provider Business Mailing Address
First Line	:	705 WELLS RD STE 300
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-2982
Country	:	US
Telephone Number	:	904-288-8311
Fax Number	:	904-288-8371

Provider Business Practice Location Address
First Line	:	8262 POINT MEADOWS DR STE 201
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-4702
Country	:	US
Telephone Number	:	904-288-8311
Fax Number	:	904-288-8371

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	10/02/2024

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Directions to “ DR. SCOTT THOMAS MILES MD” Practice Location

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