Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob Miller

Individual provider Physician Assistant · NPI 1083308605

Jacob Miller is a Physician Assistant in Fort Drum, New York. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603
Phone: (315) 772-2729
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1083308605
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 6, 2023
Last updated in NPPESAugust 25, 2025
Certification dateAugust 25, 2025
Mailing address11050 Mt Belvedere Blvd, Fort Drum, NY 13602-2603

Other providers in Fort Drum