Individual
DR. BRIAN MIXON DELOACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
658 NORTHSIDE DR E STE A, STATESBORO, GA 30458-4828
(912) 764-9684
(912) 489-8676
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
051216
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
648007516A
—
GA
Enumeration date
08/12/2006
Last updated
02/09/2026
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