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Individual

MICHAEL B MINIX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
216 CORDER RD, WARNER ROBINS, GA 31088
(478) 923-5872
(478) 922-9020
Mailing address
216 CORDER RD, WARNER ROBINS, GA 31088-3604
(478) 923-5872
(478) 922-9020

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
60671
GA
207W00000X
Ophthalmology Physician
ME80880
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
255128895C
GA
05
64322324
KY
01
P00276129
RAILROAD MEDICARE
Enumeration date
07/22/2006
Last updated
06/13/2018
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