Organization
DONALD J. MIRATE, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD JOHN MIRATE M.D. (PRESIDENT)
(229) 242-8852
Entity
Organization
Contact information
Practice address
2707 N FORREST ST, VALDOSTA, GA 31602-2057
(229) 242-8852
(229) 247-2609
Mailing address
2707 N FORREST ST, VALDOSTA, GA 31602-2057
(229) 242-8852
(229) 247-2609
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
21261
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00300121A
—
GA
Enumeration date
03/14/2007
Last updated
10/17/2008
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