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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

OLUBANSILE A MIMIKO, M.D.

Active Sole Proprietor

OLUBANSILE A MIMIKO, M.D. is a Specialist healthcare provider located in EASTMAN, Georgia. NPI 1336239177 is currently active in the NPPES registry. Verify at CMS.

Specialist · EASTMAN, GA

Registration Details

NPI Number
1336239177
Provider Type
Individual
Gender
Male
NPI Issued
Oct 13, 2006 (19.656437534064 yrs)
Last Updated
Jul 8, 2007
License
050663 (GA)
Sole Proprietor
Yes

Practice Information

Address
521 GRIFFIN AVE
EASTMAN, GA, 310236712
Browse GA providers · Browse ZIP 31023
Phone
4783744128
Primary Specialty
Specialist
174400000X

Other Specialist Providers in EASTMAN, GA

Name Credential NPI
KUO L LEE MD 1659370682
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.