NPIMap

Organization Active NPI

Dr Jack D Miller LTD

Doing business as Drs Miller and Miller

  • Optometrist
  • Eunice, LA
National Provider Identifier
1821212416
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
941-084T Issued in LA
Legal business name
DR JACK D MILLER LTD
Doing business as
Drs Miller and Miller
Practice address
350 Moosa Blvd
Eunice, LA 70535-3626
Phone
(337) 457-5277
Fax
(337) 457-5271
NPI assigned
Apr 13, 2007
Last updated
Apr 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jack D Miller Jr., OD
Title
Owner
Phone
(337) 457-5277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 941-084T LA Primary

Addresses

Primary practice location

350 Moosa Blvd
Eunice, LA 70535-3626

Mailing address

350 Moosa Blvd
Eunice, LA 70535-3626
Phone (337) 457-5277

Other identifiers 3

IdentifierTypeStateIssuer
1340952MedicaidLA
2105BOtherLABLUE CROSS BLUE SHIELDPIN
0289830001OtherLACIGNA GOVERMENT SERVICES

Other names 1

  • Drs Miller and Miller Doing business as

National Provider Directory

National Provider Directory

Locations

350 Moosa Blvd
Eunice, LA 70535
Phone (337) 457-5277

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1821212416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 MOOSA BLVD",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705353626",
            "telephone_number": "337-457-5277",
            "fax_number": "337-457-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 MOOSA BLVD",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705353626",
            "telephone_number": "337-457-5277",
            "fax_number": "337-457-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JACK D MILLER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-457-5277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "LA",
            "license": "941-084T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1340952",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELDPIN",
            "identifier": "2105B",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOVERMENT SERVICES",
            "identifier": "0289830001",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drs Miller and Miller",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eunice, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.