Provider Demographics
NPI:1164853354
Name:MILAM, CHRISTOPHER MOORE (ABOM)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:MOORE
Last Name:MILAM
Suffix:
Gender:M
Credentials:ABOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3920 HILLSBORO CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2707
Mailing Address - Country:US
Mailing Address - Phone:615-297-9017
Mailing Address - Fax:615-297-3525
Practice Address - Street 1:3920 HILLSBORO CIR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2707
Practice Address - Country:US
Practice Address - Phone:615-297-9017
Practice Address - Fax:615-297-3525
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPO000000791156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician