James Miller
Individual provider Active NPI Other Technician · Hayden, IN
NPI 1962214478 · NPPES record last updated Jan 22, 2025
Key facts
- NPI
- 1962214478
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Other Technician 247200000X
- License
- 239562 (IN)
- Practice address
- PO Box 4
Hayden, IN 47245-0004 - Phone
- (812) 767-5657
- NPI assigned
- Jan 22, 2025
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 239562 | IN | MD | Other Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | 239562 | IN | Yes |
Addresses
Primary practice location
PO Box 4
Hayden, IN 47245-0004
Mailing address
PO Box 4
Hayden, IN 47245-0004
Phone (812) 767-5657
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.