JACK W MILLER
Ambulatory Health at Professional Pl, Carrollton, GA

License number
Georgia 044541
Category
Ambulatory Health
Type
Adult Mental Health
Owner
Name: DR. JACK W MILLER MD
Title: PHYSICIAN
Phone: (770) 830-7039
Address
Address
100 Professional Pl STE 104, Carrollton, GA 30117
National Provider ID: 1982708368
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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JACK W. MILLER, M.D., PC

Carrollton, GA

Industry:
Medical Doctor's Office
Doing business as:
Jack W Miller MD PC
Registration:
Apr 21, 2003
Addresses:
100 Professional Park SUITE #104, Carrollton, GA 30117 (Physical)
100 Professional Pl, Carrollton, GA 30117
State ID:
0320859
Business type:
Domestic Professional Corporation
Medical Doctors:
W Jack Miller (CFO), 100 Professional Pl STE 104, Carrollton, GA 30117 (Physical),Jack W. Miller (Owner),Jack L. Crews (Medical Doctor)
Agent:
Dr. David E. Schoenfield,302 Tanglewood Trl, Carrollton, GA (Physical)

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