Individual
DR. BLAKE E MILNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 GRIFFIN AVE, EASTMAN, GA 31023-9101
(478) 374-8998
(478) 374-8525
Mailing address
1111 GRIFFIN AVE, 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
01
—
002243
BLUE CROSS BLUE SHIELD
GA
01
—
043644539A
MEDICAID
GA
01
—
109050
PEACH STATE HEALTH PLAN
GA
01
—
170591
WELLCARE
GA
Enumeration date
08/25/2006
Last updated
06/17/2014
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