Organization
ROBERT D. MIXSON MD PA A GEORGIA CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DAVID MIXSON M.D. (OWNER)
(912) 882-7100
Entity
Organization
Contact information
Practice address
104 LAKESHORE DR, STE A, SAINT MARYS, GA 31558-3803
(912) 882-7100
(912) 882-9149
Mailing address
104 LAKESHORE DR, STE A, SAINT MARYS, GA 31558-3803
(912) 882-7100
(912) 882-9149
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
39415
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000643431A
—
GA
Enumeration date
06/18/2008
Last updated
12/12/2013
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