MEDICARE: JOHN PAUL MILLER 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	207N00000X	Dermatology Physician	327200	LA

General Provider Information

NPI Number	:	1124588140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN PAUL MILLER MD

Provider Business Mailing Address
First Line	:	105 DR MICHAEL DEBAKEY DR
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-5950
Country	:	US
Telephone Number	:	337-240-6183
Fax Number	:	337-388-9347

Provider Business Practice Location Address
First Line	:	105 DR MICHAEL DEBAKEY DR
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-5950
Country	:	US
Telephone Number	:	337-240-6183
Fax Number	:	337-388-9347

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

Provider Enumeration Date	:	03/25/2019
Last Update Date	:	02/06/2026

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