Provider Demographics
NPI:1508970773
Name:MILLER, JASON CARL (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:CARL
Last Name:MILLER
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:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:TELLICO PLAINS
Mailing Address - State:TN
Mailing Address - Zip Code:37385-0608
Mailing Address - Country:US
Mailing Address - Phone:142-325-3600
Mailing Address - Fax:
Practice Address - Street 1:707 VETERANS MEMORIAL DRIVE
Practice Address - Street 2:
Practice Address - City:TELLICO PLAINS
Practice Address - State:TN
Practice Address - Zip Code:37385
Practice Address - Country:US
Practice Address - Phone:423-253-6003
Practice Address - Fax:423-253-6888
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23881183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist