Individual
DR. ANTHONY MIMMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6447 S EAST ST, INDIANAPOLIS, IN 46227-2118
(317) 781-0067
Mailing address
6447 S EAST ST, INDIANAPOLIS, IN 46227-2118
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
01059908A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200500320
—
IN
Enumeration date
11/16/2005
Last updated
03/15/2021
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