Active NPI
Edward John Miller Jr., D.O.
- Obstetrics & Gynecology Physician
- Douglas, AZ
National Provider Identifier
1003817263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 02480
- Practice address
- 100 E 5TH St
Douglas, AZ 85607-2859 - Phone
- (520) 364-7659
- Fax
- (520) 364-8541
- NPI assigned
- Aug 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 1279 | VI | |
| Obstetrics & Gynecology Physician | 207V00000X | 02480 | AZ | Primary |
Addresses
Primary practice location
100 E 5TH St
Douglas, AZ 85607-2859
Mailing address
101 Cole Ave
Bisbee, AZ 85603-1327
Phone (520) 432-6481
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | edwardmiller@cqch.cernerdirect.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02480 | AZ | MD | Obstetrics & Gynecology Physician |
| 2480 | AZ | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617321600000",
"number": "1003817263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 COLE AVE",
"city": "BISBEE",
"state": "AZ",
"postal_code": "856031327",
"telephone_number": "520-432-6481",
"fax_number": "520-432-5082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E 5TH ST",
"city": "DOUGLAS",
"state": "AZ",
"postal_code": "856072859",
"telephone_number": "520-364-7659",
"fax_number": "520-364-8541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "EDWARD",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-09",
"last_updated": "2021-04-02",
"certification_date": "2021-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "VI",
"license": "1279",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "AZ",
"license": "02480",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "edwardmiller@cqch.cernerdirect.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "101 Cole Ave",
"city": "Bisbee",
"state": "AZ",
"country_code": "US",
"postal_code": "856031327",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Douglas, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.