Provider Demographics
NPI:1366728487
Name:BAPTISTE, MILTON
Entity type:Individual
Prefix:
First Name:MILTON
Middle Name:
Last Name:BAPTISTE
Suffix:
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 1:515 BEVERLY RANDOLPH DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-8986
Mailing Address - Country:US
Mailing Address - Phone:615-898-1682
Mailing Address - Fax:615-898-1682
Practice Address - Street 1:515 BEVERLY RANDOLPH DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-8986
Practice Address - Country:US
Practice Address - Phone:615-898-1682
Practice Address - Fax:615-898-1682
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN028285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist