Provider Demographics
NPI:1053374496
Name:MILLER, JOSEPH E (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 180728
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72918-0728
Mailing Address - Country:US
Mailing Address - Phone:479-385-9001
Mailing Address - Fax:479-763-1156
Practice Address - Street 1:9001 JENNY LIND RD STE 3
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72908-8629
Practice Address - Country:US
Practice Address - Phone:479-385-9001
Practice Address - Fax:479-763-1156
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-022012081P2900X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR137328001Medicaid
ARF61618Medicare UPIN
AR137328001Medicaid