MEDICARE: WILLIAM M MILAM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD0000009974	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3728046	OTHER	TN	GROUP NUMBER FOR MEDICARE

General Provider Information

NPI Number	:	1477556959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM M MILAM M.D.

Provider Business Mailing Address
First Line	:	1970 N JACKSON ST
Second Line	:
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-8240
Country	:	US
Telephone Number	:	931-455-3399
Fax Number	:	931-455-1806

Provider Business Practice Location Address
First Line	:	1970 N JACKSON ST
Second Line	:
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-8240
Country	:	US
Telephone Number	:	931-455-3399
Fax Number	:	931-455-1806

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	05/19/2011

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Directions to “ WILLIAM M MILAM M.D.” Practice Location

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