MEDICARE: DR. JOHN THOMAS MILLER D.C.

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	111N00000X	Chiropractor	939	MS

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
2	640904421	OTHER	MS	TAX ID

General Provider Information

NPI Number	:	1336173798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN THOMAS MILLER D.C.

Provider Business Mailing Address
First Line	:	2220 HIGHWAY 45 N
Second Line	:
City	:	MERIDIAN
State	:	MS
Zip	:	39301-2709
Country	:	US
Telephone Number	:	601-482-7300
Fax Number	:	601-482-7380

Provider Business Practice Location Address
First Line	:	2220 HIGHWAY 45 N
Second Line	:
City	:	MERIDIAN
State	:	MS
Zip	:	39301-2709
Country	:	US
Telephone Number	:	601-482-7300
Fax Number	:	601-482-7380

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	07/08/2007

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