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Individual

MR. ROBERT DAVID MIXSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

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
174400000X
Specialist
Primary
039415
GA

Other

Enumeration date
06/30/2005
Last updated
09/03/2015
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