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Organization

BLAKE E. MILNER, M.D. P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BLAKE E. MILNER M.D. (PRESIDENT)
(478) 374-8998
Entity
Organization

Contact information

Practice address
1111 GRIFFIN AVE, STE. 1B, EASTMAN, GA 31023-9101
(478) 374-8998
(478) 374-8525
Mailing address
1111 GRIFFIN AVE, STE. 1B, EASTMAN, GA 31023-9101
(478) 374-8998
(478) 374-8525

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
052789
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
043644539A
GA
01
170591
WELLCARE OF GEORGIA
GA
01
275410
PEACH STATE HEALTH PLAN
GA
01
52070342
BLUE CROSS BLUE SHIELD OF
GA
Enumeration date
05/11/2007
Last updated
10/04/2012
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