Provider Demographics
NPI:1831433341
Name:MILAM, JOHN D (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:MILAM
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 TABORLAKE CV
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-7721
Mailing Address - Country:US
Mailing Address - Phone:859-266-9418
Mailing Address - Fax:
Practice Address - Street 1:1209 TABORLAKE CV
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-7721
Practice Address - Country:US
Practice Address - Phone:859-266-9418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008556183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist