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Individual

DR. BLANE A MIRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
46 SERGEANT PRENTISS DR, SUITE 300, NATCHEZ, MS 39120-4725
(601) 446-7343
(601) 445-0833
Mailing address
209 GLENWOOD DR, NATCHEZ, MS 39120-4707
(601) 446-8599

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
15913
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00119463
MS
Enumeration date
06/16/2006
Last updated
07/02/2010
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