Provider Demographics
NPI:1679782486
Name:MILLER, FRANK LESTER III
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:LESTER
Last Name:MILLER
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:956 EASTWOOD TER
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-1312
Mailing Address - Country:US
Mailing Address - Phone:901-861-9521
Mailing Address - Fax:
Practice Address - Street 1:100 STAR SHOPPING CTR ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-3000
Practice Address - Country:US
Practice Address - Phone:901-476-9444
Practice Address - Fax:901-476-5653
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6730183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist