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NPI Code Detail

MEDICARE: ELIZABETH BARNES MIXSON M.D.

MEDICARE:   ELIZABETH BARNES MIXSON  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician038056GA

General Provider Information

NPI Number : 1972539716
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH BARNES MIXSON M.D.
Provider Business Mailing Address
First Line : 1678 OAK LN NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-2516
Country : US
Telephone Number : 404-728-8235
Fax Number :
Provider Business Practice Location Address
First Line : 3931 MUNDY MILL RD
Second Line :
City : OAKWOOD
State : GA
Zip : 30566-3413
Country : US
Telephone Number : 404-728-8235
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 07/08/2007

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Directions to “ ELIZABETH BARNES MIXSON M.D.” Practice Location

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