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NPI Code Detail

MEDICARE: DR. JAY KENNETH MILLER MD

MEDICARE: DR. JAY KENNETH 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
1207Q00000XFamily Medicine PhysicianMD022262EPA

General Provider Information

NPI Number : 1417908310
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAY KENNETH MILLER MD
Provider Business Mailing Address
First Line : 471 HEPBURN ST
Second Line : COMMUNITY HEALTH CENTER
City : WILLIAMSPORT
State : PA
Zip : 17701-6122
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 471 HEPBURN ST
Second Line : COMMUNITY HEALTH CENTER
City : WILLIAMSPORT
State : PA
Zip : 17701-6122
Country : US
Telephone Number : 570-567-5400
Fax Number : 570-567-5421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 07/08/2007

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