Jack W Miller

NPI #1982708368 in Carrollton, Georgia

Provider Information

NPI Number
1982708368
Entity Type
Organization
Organization Name
Jack W Miller
Primary Specialty
Clinic/Center - Adult Mental Health
Enumeration Date
Sep 7, 2006
Last Updated
Feb 2, 2011

Practice Location

Address
100 PROFESSIONAL PL
Address 2
STE 104
State
Georgia
ZIP Code
30117-3874
Phone
(770) 830-7039

Authorized Official

Name
DR. JACK W MILLER, MD
Title
PHYSICIAN
Phone
(770) 830-7039

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Adult Mental HealthAdult Mental Health

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