Individual
MR. EMMETT PAUL MILAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.C.D., CCC-SLP
Contact information
Practice address
2208 FOWLER AVE, SUITE C, JONESBORO, AR 72401-6115
(870) 931-0808
(870) 972-0929
Mailing address
2607 COTTONWOOD ST, JONESBORO, AR 72401-5620
(870) 933-2510
(870) 972-0929
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1439
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5U979
BLUE CROSS & BLUE SHIELD
AR
Enumeration date
07/19/2006
Last updated
07/09/2007
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