Individual
MRS. JACQUELINE DENISE MILAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
490 DUNLOP LN, CLARKSVILLE, TN 37040-5007
(931) 245-8300
(931) 245-8360
Mailing address
PO BOX 3799, CLARKSVILLE, TN 37043-3799
(931) 245-7000
(931) 245-7068
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21903
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q004447
—
TN
Enumeration date
11/08/2005
Last updated
08/29/2022
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