Deloach, Brian Mixon
Deloach, Brian Mixon is an individual health care provider with primary practice located at 658 Northside Dr E Ste A , Statesboro GA 30458-4828. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Deloach, Brian Mixon can be contacted via phone (912) 764-9684.Contact Information
Primary practice address
658 Northside Dr E Ste A
Statesboro GA 30458-4828
Phone: (912) 764-9684
Fax: (912) 489-8676
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 051216 | Georgia |
Profile Details
| NPI number | 1841202868 |
|---|---|
| LBN Legal business name | Deloach, Brian Mixon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 12th, 2006 |
| Last updated | Mar 11th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841202868 | NPPES |
| Georgia | MEDICAID | 648007516A |
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