Individual
DR. CHARLES M. MIXSON
Active
Individual
DR. CHARLES M. MIXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207YS0012X
Sleep Medicine (Otolaryngology) Physician
Primary
052997
GA
207YS0123X
Facial Plastic Surgery Physician
052997
GA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
052997
GA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
052997
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
052997
GA. STATE LICENSE
GA
Enumeration date
11/06/2006
Last updated
10/24/2012
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