Mixon, John W

Mixon, John W is an individual health care provider with primary practice located at 1119 E Lamar St , Americus GA 31709-3762. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mixon, John W can be contacted via phone (229) 924-4022.

Contact Information

Primary practice address
1119 E Lamar St Americus GA 31709-3762
Fax: (229) 924-7133
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT002265 Georgia

Profile Details

NPI number 1750365276
LBN Legal business name Mixon, John W
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Nov 6th, 2008 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750365276 NPPES
Georgia MEDICAID 732994221A
Georgia MEDICAID 732994221C
Georgia MEDICAID 732994221B

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