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General NPI Number Information
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NPI Number | 1336256015
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Entity Type | Individual
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Provider Name | BLAKE E MILNER M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 06/17/2014
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Provider Practice Location Address
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Address Line | 1111 GRIFFIN AVE
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City | EASTMAN
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State | GA
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Zip | 31023-9101
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Country | US
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Telephone | 478-374-8998
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Fax | 478-374-8525
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Provider Business Mailing Address
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Address Line | 1111 GRIFFIN AVE
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City | EASTMAN
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State | GA
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Zip | 31023-9101
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Country | US
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Telephone | 478-374-8998
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Fax | 478-374-8525
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 052789
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License Number State | GA
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