Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | E-02201 | AR |
N | 208200000X | Surgeon | E-02201 | AR |
N | 208600000X | Surgeon | E-02201 | AR |
NPI | 1053374496 |
---|---|
Provider Name | Joseph E Miller |
First Address | Fort Smith, AR 72918-0728 |
Second Address | Fort Smith, AR 72908-8629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 20/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
137328001 | (05) | AR |
F61618 | (02) | AR |