Provider Demographics
NPI:1871586131
Name:HAROLD J MILLER MD LLC
Entity type:Organization
Organization Name:HAROLD J MILLER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:985-429-8168
Mailing Address - Street 1:15770 PAUL VEGA MD DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1475
Mailing Address - Country:US
Mailing Address - Phone:985-429-8168
Mailing Address - Fax:985-429-8712
Practice Address - Street 1:15770 PAUL VEGA MD DR
Practice Address - Street 2:SUITE 202
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1475
Practice Address - Country:US
Practice Address - Phone:985-429-8168
Practice Address - Fax:985-429-8712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09306R207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CK36Medicare PIN